Mesenteric Ischemia

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“Mesentery” is used to describe the substance found in the abdomen that helps holds the intestine in place to the abdominal wall. It contains blood vessels that supply the intestine.  Ischemia is said to happen when blood flow is limited or affected due to a blockage in the blood vessels of a particular area.  What […] Read More

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Mesenteric Ischemia

“Mesentery” is used to describe the substance found in the abdomen that helps holds the intestine in place to the abdominal wall. It contains blood vessels that supply the intestine.  Ischemia is said to happen when blood flow is limited or affected due to a blockage in the blood vessels of a particular area.  What is Mesenteric Ischemia? Mesenteric Ischemia, also called ‘Bowel Infarction’, is the narrowing or blockage of arteries supplying the intestine, resulting in restricted blood flow to the intestine, which could lead to damage in the intestine as oxygen intake is also affected. Types of Mesenteric Ischemia Mesenteric ischemia can be classified into:
  • Acute Mesenteric Ischemia
It is characterized by a sudden interruption of blood flow to the different parts of the small intestine, which could lead to inflammatory changes, ischemia, cellular damage and death, and sometimes intestinal necrosis. Here, symptoms could occur promptly without any indication, resulting in serious health complications even death. It is mostly treated with surgery.
  • Chronic Mesenteric Ischemia
Chronic Mesenteric Ischemia is progressive and builds up slowly. It could happen due to a blockage in the major arteries supplying the small intestine blood. When left untreated, it could progress to being acute. It can be treated using angioplasty. Risk Factors of Mesenteric Ischemia Certain factors can lead to Mesenteric Ischemia. They include:
  • Age; usually people older than 60.
  • High cholesterol
  • Coronary heart diseases
  • People who smoke a lot
Complications of Mesenteric Ischemia The complications that can arise if the condition is not treated on time can include:
  • Sepsis; a condition where the body overreacts to chemicals released to fight infections, leading to multiple organ failure.
  • Acute-on-chronic form of the condition.
  • Parts of the bowel begins to die, which can lead to irreversible intestinal damage.
  • Death in extreme cases.
Diagnoses of Mesenteric Ischemia Mesenteric Ischemia can be diagnosed through:
  • A blood test to check for intestinal ischemia.
  • Imaging tests such as computerized tomography scan and X-ray, which are used to get images of the intestine.
  • Endoscopy is done. This involves putting a lighted flexible tube with a camera on it’d tip into your mouth or rectum. An image of your gastrointestinal tract is viewed,  then the upper of your small intestine is examined or if inserted through your rectum, the colon is viewed.
  • A test that involves using a dye to trace the flow of blood in the arteries can also be used called angiography. Here, a long tube called a catheter is placed into an artery in your arm or groin, then passed through the artery to the aorta and the dye injected through the catheter flows directly into your intestinal artery. Hence, narrow areas of the arteries are located.
  • Open or exploratory surgery is done.
Treatment of Mesenteric Ischemia For Acute Mesenteric Ischemia, treatment involves:
  • Surgery is mostly recommended to remove blood clots, bypass an artery blockage, and remove damaged intestine.
  • Medication such as antibiotics is also used to dissolve clots and dilate blood vessels.
  • A stent may be used to keep the artery open.
Treatment for Chronic Mesenteric Ischemia includes:
  • Angioplasty surgery or therapy.
  • Medications such as anticoagulant.
  • Also, a stent might be used to keep the artery open.
  • Trans-aortic Endarterectomy; a process of removing the plaque blocking the artery, can be done.
Prevention of Mesenteric Ischemia This condition can be prevented through:
  • Avoiding smoking
  • Healthy feeding
  • Regular exercises
  • Reduce meal with high cholesterol
  • Avoiding stress that might lead to high blood pressure.
Recovery When treatments are done early enough to stop complications from arising, recovery can take 4 to 8 weeks. However, your doctor may resist your activities and you will have a follow-up call you are recovered. Make sure to rest frequently, eat healthily, reduce intake of cholesterol, quit smoking, and exercise often.

Symptoms

Symptoms of Mesenteric Ischemia

The symptoms of Mesenteric Ischemia can be acute or chronic:

Acute Mesenteric Ischemia

They include:

  • Abrupt and severe abdominal pain
  • Urgent need to have a bowel movement
  • Fever
  • Nausea and vomiting

Chronic Mesenteric Ischemia

  • Abdominal pain, which begins about 30 minutes after eating and worsens over an hour.
  • Pain, which goes away within one to three hours.
  • Weight loss.
  • Flatulence.

If the pain becomes severe and abrupt abdominal pain that persists, then you need to see the doctor.

Causes

Causes of Mesenteric Ischemia

It is caused by slow or insufficient blood flow to the small intestine. Although acute Mesenteric Ischemia could also result from a blood clot in the Mesenteric artery, which could originate from the heart while the chronic is caused by an assimilated of plaque that narrows the blood vessels.

Some other causes include:

  • Aortic dissection; a tear in the aorta's inner layer.
  • Coagulation disorders
  • Congestive heart failure
  • Low blood pressure
  • Occlusion or blockage of the veins in the bowel
  • Fibromuscular dysplasia and arthritis that is Disorders of the blood.

FAQ

What is the difference between Acute Mesenteric Ischemia and Chronic Mesenteric Ischemia?

Mesenteric ischemia could be acute or chronic. 

Acute mesenteric ischemia is characterized by sudden symptoms, resulting in a serious health crisis even death while chronic mesenteric ischemia, develops gradually over time, and rapidly progresses to an acute crisis without warning.

What is Mesenteric artery stenosis?

Mesenteric artery stenosis is the insufficient blood flow to the small intestine, causing intestinal ischemia. 

Is Mesenteric Ischemia painful?

Mesenteric ischemia happens when one or more of the mesenteric arteries becomes narrows or blocked. When this happens, severe abdominal pain is felt and over time, the blockage may worsen, resulting in the death of some tissues in the intestine due to lack of enough blood flow.

Can block arteries cause stomach problems?

Yes, due to the sudden and sometimes complete blockage of the superior mesenteric artery. It could maybe be accompanied by nausea and vomiting and should be treated as a medical emergency. 

Who can be affected?

Anyone can be affected but it is predominantly found among:

The elderly

Hypertensive people

Obese people

Smokers, etc.