Intestinal ischemia resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2]

Definition

Intestinal ischemia are a heterogeneous group of diseases characterized by hypoxia of the small bowel and/or colon, which most commonly arises from occlusion, vasospasm, and/or hypoperfusion of the mesenteric vasculature.[1] Intestinal ischemic disorders have been classified into the following three major types.[2][3]

Clinical subgroups Definitions
Acute mesenteric ischemia It includes superior mesenteric artery embolism (SMAE) (50%); nonocclusive mesenteric ischemia (NOMI) (20% to 30%); superior mesenteric artery thrombosis (SMAT) (15% to 25%); and superior mesenteric vein (SMV) thrombosis (5%).
Chronic mesenteric ischemia It usually refers to intestinal angina.
Colonic ischemia (CI) It includes reversible ischemic colopathy, transient ulcerating ischemic colitis, chronic ulcerating ischemic colitis, colonic stricture, colonic gangrene, and fulminant universal ischemic colitis.

Causes

Life Threatening Causes

Common Causes

Management

The algorithm is based on the American College of Gastroenterology guidelines for management of Intestinal Ischemia in adults.


Do's

Dont's

References

  1. Gore RM, Thakrar KH, Mehta UK, Berlin J, Yaghmai V, Newmark GM (2008). "Imaging in intestinal ischemic disorders". Clin Gastroenterol Hepatol. 6 (8): 849–58. doi:10.1016/j.cgh.2008.05.007. PMID 18674733.
  2. Greenwald DA, Brandt LJ, Reinus JF (2001). "Ischemic bowel disease in the elderly". Gastroenterol Clin North Am. 30 (2): 445–73. PMID 11432300.
  3. Lock G (2001). "Acute intestinal ischaemia". Best Pract Res Clin Gastroenterol. 15 (1): 83–98. doi:10.1053/bega.2000.0157. PMID 11355902.


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