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__NOTOC__
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{{Mesenteric ischemia}}
{{Mesenteric ischemia}}
{{CMG}} {{AE}} {{FT}}
{{CMG}}; {{AE}}{{FT}}
==Overview==
==Overview==
Risk factors causing mesenteric ischemia can be divided based on the underlying etiology. Conditions posing 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.   
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==
==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|mesenteric]] ischemia in the older age group. <ref name="pmid10917470">{{cite journal| author=Fitzgerald T, Kim D, Karakozis S, Alam H, Provido H, Kirkpatrick J| title=Visceral ischemia after cardiopulmonary bypass. | journal=Am Surg | year= 2000 | volume= 66 | issue= 7 | pages= 623-6 | pmid=10917470 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10917470  }} </ref><ref name="pmid9746774">{{cite journal| author=Martinelli I, Mannucci PM, De Stefano V, Taioli E, Rossi V, Crosti F et al.| title=Different risks of thrombosis in four coagulation defects associated with inherited thrombophilia: a study of 150 families. | journal=Blood | year= 1998 | volume= 92 | issue= 7 | pages= 2353-8 | pmid=9746774 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9746774  }} </ref><ref name="pmid16476108">{{cite journal| author=Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M| title=Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors. | journal=J Intern Med | year= 2006 | volume= 259 | issue= 3 | pages= 305-13 | pmid=16476108 | doi=10.1111/j.1365-2796.2006.01613.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16476108  }} </ref>
* 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|mesenteric]] ischemia in the older age group.<ref name="pmid10917470">{{cite journal| author=Fitzgerald T, Kim D, Karakozis S, Alam H, Provido H, Kirkpatrick J| title=Visceral ischemia after cardiopulmonary bypass. | journal=Am Surg | year= 2000 | volume= 66 | issue= 7 | pages= 623-6 | pmid=10917470 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10917470  }} </ref><ref name="pmid9746774">{{cite journal| author=Martinelli I, Mannucci PM, De Stefano V, Taioli E, Rossi V, Crosti F et al.| title=Different risks of thrombosis in four coagulation defects associated with inherited thrombophilia: a study of 150 families. | journal=Blood | year= 1998 | volume= 92 | issue= 7 | pages= 2353-8 | pmid=9746774 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9746774  }} </ref><ref name="pmid16476108">{{cite journal| author=Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M| title=Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors. | journal=J Intern Med | year= 2006 | volume= 259 | issue= 3 | pages= 305-13 | pmid=16476108 | doi=10.1111/j.1365-2796.2006.01613.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16476108  }} </ref>


[[Venous thromboembolism|Venous thrombosis]] is more frequently seen in women and [[arterial thrombosis]] is more commonly seen in men.<ref name="pmid11407335">{{cite journal| author=Endean ED, Barnes SL, Kwolek CJ, Minion DJ, Schwarcz TH, Mentzer RM| title=Surgical management of thrombotic acute intestinal ischemia. | journal=Ann Surg | year= 2001 | volume= 233 | issue= 6 | pages= 801-8 | pmid=11407335 | doi= | pmc=1421323 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11407335  }} </ref><ref name="CorcosNuzzo2013">{{cite journal|last1=Corcos|first1=Olivier|last2=Nuzzo|first2=Alexandre|title=Gastro-Intestinal Vascular Emergencies|journal=Best Practice & Research Clinical Gastroenterology|volume=27|issue=5|year=2013|pages=709–725|issn=15216918|doi=10.1016/j.bpg.2013.08.006}}</ref>
* [[Venous thromboembolism|Venous thrombosis]] is more frequently seen in women and [[arterial thrombosis]] is more commonly seen in men.<ref name="pmid11407335">{{cite journal| author=Endean ED, Barnes SL, Kwolek CJ, Minion DJ, Schwarcz TH, Mentzer RM| title=Surgical management of thrombotic acute intestinal ischemia. | journal=Ann Surg | year= 2001 | volume= 233 | issue= 6 | pages= 801-8 | pmid=11407335 | doi= | pmc=1421323 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11407335  }} </ref><ref name="CorcosNuzzo2013">{{cite journal|last1=Corcos|first1=Olivier|last2=Nuzzo|first2=Alexandre|title=Gastro-Intestinal Vascular Emergencies|journal=Best Practice & Research Clinical Gastroenterology|volume=27|issue=5|year=2013|pages=709–725|issn=15216918|doi=10.1016/j.bpg.2013.08.006}}</ref>


[[Mesenteric ischemia]] is more prevalent in women as compared to males.<ref name="pmid22305578">{{cite journal| author=Veenstra RP, ter Steege RW, Geelkerken RH, Huisman AB, Kolkman JJ| title=The cardiovascular risk profile of atherosclerotic gastrointestinal ischemia is different from other vascular beds. | journal=Am J Med | year= 2012 | volume= 125 | issue= 4 | pages= 394-8 | pmid=22305578 | doi=10.1016/j.amjmed.2011.09.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22305578  }} </ref>
* [[Mesenteric ischemia]] is more prevalent in women as compared to males.<ref name="pmid22305578">{{cite journal| author=Veenstra RP, ter Steege RW, Geelkerken RH, Huisman AB, Kolkman JJ| title=The cardiovascular risk profile of atherosclerotic gastrointestinal ischemia is different from other vascular beds. | journal=Am J Med | year= 2012 | volume= 125 | issue= 4 | pages= 394-8 | pmid=22305578 | doi=10.1016/j.amjmed.2011.09.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22305578  }} </ref>
{| class="wikitable"
{| class="wikitable"
! colspan="3" |Risk factors
! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" | Risk factors
|-
|-
| rowspan="13" |Occlusive
| rowspan="13" align="center" style="background:#4479BA; color: #FFFFFF;" | Occlusive
| rowspan="7" |Embolic
| rowspan="7" |[[Embolic]]
|[[Atrial fibrillation]]
|[[Atrial fibrillation]]
|-
|-
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|[[Ventricular aneurysm]]
|[[Ventricular aneurysm]]
|-
|-
|Aortic atherosclerosis
|[[Aortic]] [[atherosclerosis]]
|-
|-
| rowspan="6" |Thrombotic
| rowspan="6" |[[Thrombotic]]
|Advanced age
|Advanced age
|-
|-
|Low cardiac output states
|Low [[cardiac output]] states
|-
|-
|[[Peripheral arterial disease]]
|[[Peripheral arterial disease]]
Line 39: Line 39:
|Traumatic injury  
|Traumatic injury  
|-
|-
|Inherited thrombophilia-  
|[[Inherited thrombophilia]]-  
* [[Factor V Leiden mutation|Factor V Leidin mutation]]
* [[Factor V Leiden mutation|Factor V Leidin mutation]]
* [[Prothrombin G20210A mutation]]
* [[Prothrombin G20210A mutation]]
Line 46: Line 46:
* [[Antithrombin III deficiency]]
* [[Antithrombin III deficiency]]
* [[Activated protein C resistance]]
* [[Activated protein C resistance]]
* Anti-phospholipid syndrome
* Antiphospholipid syndrome
* [[Myeloproliferative neoplasm|Myeloproliferative disorders(JAK2 V617F) mutation.]]
* [[Myeloproliferative neoplasm|Myeloproliferative disorders(JAK2 V617F) mutation.]]
|-
|-
|Acquired thrombophilia- malignancy, oral contraceptives intake.
|Acquired [[thrombophilia]]- [[Cancer|malignancy]], [[Oral contraceptive|oral contraceptives]] intake.
|-
|-
| colspan="2" rowspan="6" |Non-occlusive
| colspan="2" rowspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" |Non-occlusive
|Heart failure
|[[Congestive heart failure|Heart failure]]
|-
|-
|[[Aortic insufficiency]]
|[[Aortic insufficiency]]
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|[[Septic shock]]  
|[[Septic shock]]  
|-
|-
|Vasoconstrictive drugs:
|[[Vasoconstrictive]] drugs:
* [[Digoxin]]
* [[Digoxin]]
* [[Alpha-adrenergic agonist|Alpha-adrenergic agonists]]
* [[Alpha-adrenergic agonist|Alpha-adrenergic agonists]]
|-
|-
|Cocaine abuse or ergot poisoning
|[[Cocaine]] abuse or [[ergot]] poisoning
|-
|-
|[[Hemodialysis]]
|[[Hemodialysis]]
|-
|-
| colspan="2" |Other causes
| colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Other factors
|Lifestyle related risk factors:
|Lifestyle related risk factors:<ref name="DahlkeAsshoff2008">{{cite journal|last1=Dahlke|first1=M.H.|last2=Asshoff|first2=L.|last3=Popp|first3=F.C.|last4=Feuerbach|first4=S.|last5=Lang|first5=S.A.|last6=Renner|first6=P.|last7=Slowik|first7=P.|last8=Stoeltzing|first8=O.|last9=Schlitt|first9=H.J.|last10=Piso|first10=P.|title=Mesenteric Ischemia &ndash; Outcome after Surgical Therapy in 83 Patients|journal=Digestive Surgery|volume=25|issue=3|year=2008|pages=213–219|issn=1421-9883|doi=10.1159/000140692}}</ref>
* High cholesterol levels
* High [[cholesterol]] levels
* History of smoking
* History of smoking
* [[Immobility]]
* [[Immobility]]


* Recent [[surgery]]  
* [[Hypertension]]
* [[Hyperlipoproteinemia|Hyperlipidemia]]
* [[Diabetes]]  
Less common risk factors:  
Less common risk factors:  
* [[Fibromuscular dysplasia|Fibromuscular]] dysplasia
* [[Fibromuscular dysplasia|Fibromuscular]] dysplasia
* Beta receptor blocking agents
* [[Beta receptor]] blocking agents
* [[Hepatitis]]
* [[Hepatitis]]
|}
|}
*Common risk factors in the development of mesenteric ischemia include:
Common risk factors in the development of mesenteric ischemia include:
**'''Occlusive causes'''
 
***'''Embolic causes''':<ref name="pmid10917470">{{cite journal| author=Fitzgerald T, Kim D, Karakozis S, Alam H, Provido H, Kirkpatrick J| title=Visceral ischemia after cardiopulmonary bypass. | journal=Am Surg | year= 2000 | volume= 66 | issue= 7 | pages= 623-6 | pmid=10917470 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10917470  }} </ref>
=== '''Occlusive causes:''' ===
***[[Atrial fibrillation]]  
'''(a) Embolic causes''':<ref name="pmid10917470">{{cite journal| author=Fitzgerald T, Kim D, Karakozis S, Alam H, Provido H, Kirkpatrick J| title=Visceral ischemia after cardiopulmonary bypass. | journal=Am Surg | year= 2000 | volume= 66 | issue= 7 | pages= 623-6 | pmid=10917470 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10917470  }} </ref>
***[[Cardiac arrhythmia|Cardiac arrhythmias]]  
*[[Atrial fibrillation]]  
***Valvular heart diseases
*[[Cardiac arrhythmia|Cardiac arrhythmias]]  
***[[Endocarditis|Infective endocarditis]]  
*Valvular heart diseases
***Recent myocardial infarction
*[[Endocarditis|Infective endocarditis]]  
***[[Left ventricular aneurysm|Ventricular aneurysm]]
*Recent [[ST elevation myocardial infarction|myocardial]] infarction
***Aortic atherosclerosis   
*[[Left ventricular aneurysm|Ventricular aneurysm]]
***[[Aortic aneurysm]]
*Aortic [[atherosclerosis]]  
**'''Thrombotic causes''':<ref name="pmid9746774">{{cite journal| author=Martinelli I, Mannucci PM, De Stefano V, Taioli E, Rossi V, Crosti F et al.| title=Different risks of thrombosis in four coagulation defects associated with inherited thrombophilia: a study of 150 families. | journal=Blood | year= 1998 | volume= 92 | issue= 7 | pages= 2353-8 | pmid=9746774 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9746774  }} </ref>
*[[Aortic aneurysm]]
***Advanced age
'''(b) Thrombotic causes''':<ref name="pmid9746774">{{cite journal| author=Martinelli I, Mannucci PM, De Stefano V, Taioli E, Rossi V, Crosti F et al.| title=Different risks of thrombosis in four coagulation defects associated with inherited thrombophilia: a study of 150 families. | journal=Blood | year= 1998 | volume= 92 | issue= 7 | pages= 2353-8 | pmid=9746774 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9746774  }} </ref>
***Low cardiac output states
*Advanced age
***Traumatic injury
*Low [[cardiac output]] states
***[[Peripheral arterial disease|Peripheral artery disease]]
*Traumatic injury
*'''Non-occlusive causes:'''<ref name="pmid16476108">{{cite journal| author=Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M| title=Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors. | journal=J Intern Med | year= 2006 | volume= 259 | issue= 3 | pages= 305-13 | pmid=16476108 | doi=10.1111/j.1365-2796.2006.01613.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16476108  }} </ref>
*[[Peripheral arterial disease|Peripheral artery disease]]
**[[Heart failure]]
 
**[[Aortic insufficiency]]
=== '''Non-occlusive causes:'''<ref name="pmid16476108">{{cite journal| author=Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M| title=Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors. | journal=J Intern Med | year= 2006 | volume= 259 | issue= 3 | pages= 305-13 | pmid=16476108 | doi=10.1111/j.1365-2796.2006.01613.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16476108  }} </ref> ===
**[[Septic shock]]
*[[Heart failure]]
**Vasoconstrictive drugs(e.g. [[Digoxin]], [[Alpha-adrenergic agonist|alpha-adrenergic agonists)]]
*[[Aortic insufficiency]]
**[[Cocaine abuse]] or ergot poisoning
*[[Septic shock]]
**[[Hemodialysis]]
*[[Vasoconstrictive]] drugs (e.g. [[Digoxin]], [[Alpha-adrenergic agonist|alpha-adrenergic agonists)]]
*[[Cocaine abuse]] or [[ergot]] poisoning
*[[Hemodialysis]]


==References==
==References==
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Latest revision as of 12:44, 14 April 2021

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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]
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]

(b) Thrombotic causes:[2]

Non-occlusive causes:[3]

References

  1. ↑ 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. ↑ 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. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ 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.
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