Mesenteric ischemia risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
Risk factors causing mesenteric ischemia can be divided based on the underlying etiology. Conditions that pose a significant risk to the development of mesenteric ischemia include the interruption of blood flow through the artery or vein supplying the small intestine (e.g thromboembolism) or reduction of blood supply (e.g. vasoconstriction). Also, there are certain life-style related risk factors which predominantly cause mesenteric ischemia in the older age group.
Risk Factors
- The following conditions pose a significant risk towards the development of mesenteric ischemia either by interrupting the blood flow through the artery or vein supplying the small intestine (e.g.thromboemboli) or by reducing the blood supply (e.g. vasoconstriction). Also, there are certain life-style related risk factors which predominantly cause mesenteric ischemia in the older age group.[1][2][3]
- Venous thrombosis is more frequently seen in women and arterial thrombosis is more commonly seen in men.[4][5]
- Mesenteric ischemia is more prevalent in women as compared to males.[6]
| Risk factors | ||
|---|---|---|
| Occlusive | Embolic | Atrial fibrillation |
| Cardiac arrhythmia | ||
| Valvular heart disease | ||
| Infective endocarditis | ||
| Recent myocardial infarction | ||
| Ventricular aneurysm | ||
| Aortic atherosclerosis | ||
| Thrombotic | Advanced age | |
| Low cardiac output states | ||
| Peripheral arterial disease | ||
| Traumatic injury | ||
Inherited thrombophilia-
| ||
| Acquired thrombophilia- malignancy, oral contraceptives intake. | ||
| Non-occlusive | Heart failure | |
| Aortic insufficiency | ||
| Septic shock | ||
| Vasoconstrictive drugs: | ||
| Cocaine abuse or ergot poisoning | ||
| Hemodialysis | ||
| Other factors | Lifestyle related risk factors:[7]
Less common risk factors:
| |
Common risk factors in the development of mesenteric ischemia include:
Occlusive causes:
(a) Embolic causes:[1]
- Atrial fibrillation
- Cardiac arrhythmias
- Valvular heart diseases
- Infective endocarditis
- Recent myocardial infarction
- Ventricular aneurysm
- Aortic atherosclerosis
- Aortic aneurysm
(b) Thrombotic causes:[2]
- Advanced age
- Low cardiac output states
- Traumatic injury
- Peripheral artery disease
Non-occlusive causes:[3]
- Heart failure
- Aortic insufficiency
- Septic shock
- Vasoconstrictive drugs (e.g. Digoxin, alpha-adrenergic agonists)
- Cocaine abuse or ergot poisoning
- Hemodialysis
References
- ↑ 1.0 1.1 Fitzgerald T, Kim D, Karakozis S, Alam H, Provido H, Kirkpatrick J (2000). "Visceral ischemia after cardiopulmonary bypass". Am Surg. 66 (7): 623–6. PMID 10917470.
- ↑ 2.0 2.1 Martinelli I, Mannucci PM, De Stefano V, Taioli E, Rossi V, Crosti F; et al. (1998). "Different risks of thrombosis in four coagulation defects associated with inherited thrombophilia: a study of 150 families". Blood. 92 (7): 2353–8. PMID 9746774.
- ↑ 3.0 3.1 Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M (2006). "Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors". J Intern Med. 259 (3): 305–13. doi:10.1111/j.1365-2796.2006.01613.x. PMID 16476108.
- ↑ Endean ED, Barnes SL, Kwolek CJ, Minion DJ, Schwarcz TH, Mentzer RM (2001). "Surgical management of thrombotic acute intestinal ischemia". Ann Surg. 233 (6): 801–8. PMC 1421323. PMID 11407335.
- ↑ Corcos, Olivier; Nuzzo, Alexandre (2013). "Gastro-Intestinal Vascular Emergencies". Best Practice & Research Clinical Gastroenterology. 27 (5): 709–725. doi:10.1016/j.bpg.2013.08.006. ISSN 1521-6918.
- ↑ Veenstra RP, ter Steege RW, Geelkerken RH, Huisman AB, Kolkman JJ (2012). "The cardiovascular risk profile of atherosclerotic gastrointestinal ischemia is different from other vascular beds". Am J Med. 125 (4): 394–8. doi:10.1016/j.amjmed.2011.09.013. PMID 22305578.
- ↑ Dahlke, M.H.; Asshoff, L.; Popp, F.C.; Feuerbach, S.; Lang, S.A.; Renner, P.; Slowik, P.; Stoeltzing, O.; Schlitt, H.J.; Piso, P. (2008). "Mesenteric Ischemia – Outcome after Surgical Therapy in 83 Patients". Digestive Surgery. 25 (3): 213–219. doi:10.1159/000140692. ISSN 1421-9883.