Sandbox:Feham
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]
Overview
Mesenteric ischemia is a type of intestinal ischemia primarily affecting the small intestine. It is one of the life-threatening gastrointestinal vascular emergencies which requires prompt surgical/medical intervention depending upon the underlying cause.
Common causes in the development of mesenteric ischemia can be divided into occlusive/non-occlusive, arterial or venous, localized/generalized and superficial or transmural.[1]
Risk Factors
Common Risk Factors
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 |
- Common risk factors in the development of mesenteric ischemia include:
- Non-modifiable causes**
- Age >60 years
- High cholesterol levels
- History of smoking
- Occlusive causes
- Embolic causes:[2]
- Atrial fibrillation
- Cardiac arrhythmias
- Valvular heart diseases
- Infective endocarditis
- Recent myocardial infarction
- Ventricular aneurysm
- Aortic atherosclerosis
- Aortic aneurysm
- Thrombotic causes:[3]
- Advanced age
- Low cardiac output states
- Traumatic injury
- Peripheral artery disease
- Non-modifiable causes**
- Non-occlusive causes:[4]
- Heart failure
- Aortic insufficiency
- Septic shock
- Vasoconstrictive drugs(e.g. Digoxin, alpha-adrenergic agonists)
- Cocaine abuse or ergot poisoning
Less Common Risk Factors
- Less common risk factors in the development of [disease name] include:
- [Risk factor 1]
- [Risk factor 2]
- [Risk factor 3]
Causes
Mesenteric ischemia may be caused by the processes that compromise the blood flow to the small intestines. Any factor that can compromise the blood supply to the affected organ; either by reducing the perfusion( low blood pressure or vasoconstriction) or by promoting the formation of thromboemboli(blood clots).It can be classified according to the time course of onset, quality of symptoms and the degree to which the blood flow is compromised. The most commom cause of mesenteric ischemia is superior mesneteric artery occlusion.
Classification based on etiology | |||
---|---|---|---|
Etiology | Cause | Incidence | Risk factors |
Occlusive causes | Aterial embolism | 50-70% |
|
Arterial thrombosis | 15-25% |
| |
Venous thrombosis | 5% |
| |
Non-Occlusive causes | Non-occlusive ischemia | 20-30% |
|
Life-threatening Causes[edit | edit source] Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. There are no life-threatening causes of disease name, however complications resulting from untreated disease name is common. Life-threatening causes of [symptom/manifestation] include [cause1], [cause2], and [cause3]. [Cause] is a life-threatening cause of [disease]. Common Causes[edit | edit source] [Disease name] may be caused by:
References
- ↑ Corcos O, Nuzzo A (2013). "Gastro-intestinal vascular emergencies". Best Pract Res Clin Gastroenterol. 27 (5): 709–25. doi:10.1016/j.bpg.2013.08.006. PMID 24160929.
- ↑ 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.
- ↑ 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.
- ↑ 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.