Chronic mesenteric ischemia
- David A Tendler, MD
David A Tendler, MD
- Assistant Consulting Professor of Medicine
- Duke University
- J Thomas Lamont, MD
J Thomas Lamont, MD
- Editor-in-Chief — Gastroenterology/Hepatology
- Section Editor — Anorectal Disorders and Misc. Lower GI Disease
- Section Editor — Nutrition, Malabsorption, and Misc. Upper GI Disease
- Professor of Medicine
- Harvard Medical School
- Section Editors
- John F Eidt, MD
John F Eidt, MD
- Section Editor — Vascular Surgery
- Professor of Surgery
- University of South Carolina School of Medicine Greenville
- Joseph L Mills, Sr, MD
Joseph L Mills, Sr, MD
- Section Editor — Vascular Surgery
- Professor of Surgery
- University of Arizona Health Sciences Center
- David I Soybel, MD
David I Soybel, MD
- Editor-in-Chief — General Surgery
- Section Editor — Upper GI Surgery
- David L. Nahrwold Professor
- Penn State Hershey Medical Center
Mesenteric ischemia is caused by a reduction in intestinal blood flow, which most commonly arises from occlusion, vasospasm and/or hypoperfusion of the mesenteric vasculature. The clinical consequences can be catastrophic, including sepsis, bowel infarction, and death, making rapid diagnosis and treatment imperative.
Intestinal ischemia can be divided into acute and chronic, based upon the rapidity and the degree to which blood flow is compromised.
●Acute mesenteric ischemia refers to the sudden onset of intestinal hypoperfusion, which can be due to occlusive or nonocclusive obstruction of arterial or venous blood flow. Occlusive arterial obstruction is most commonly due to emboli or thrombosis of mesenteric arteries while occlusive venous obstruction is most commonly due to thrombosis or segmental strangulation. Nonocclusive arterial hypoperfusion is most commonly due to primary splanchnic vasoconstriction.
●Chronic mesenteric ischemia (also called intestinal angina) refers to episodic or constant intestinal hypoperfusion, which usually develops in patients with mesenteric atherosclerotic disease.
Chronic mesenteric ischemia involving the small intestine will be reviewed here. The anatomy of the mesenteric vasculature, acute mesenteric small intestinal ischemia, and colonic ischemia are discussed separately. (See "Overview of intestinal ischemia in adults" and "Colonic ischemia".)
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