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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

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/venous, localized/generalized and superficial/transmural.[1]

Risk Factors

  • Mesenteric ischemia can be caused by any factor that can compromise the blood supply to the affected organ; either by reducing the perfusion or by promoting the formation of thromboemboli. It can be broadly classified as occlusive and non-occlusive.
  • The most potent risk factor in the development of mesenteric ischemia is superior mesenteric artery occlusion.

Common Risk Factors

  • Common risk factors in the development of mesenteric ischemia include:
  • Occlusive causes
  • Embolic causes:[2]
  • Atrial fibrillation
  • Cardiac arrhythmias
  • Cardiac valvular 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-occlusive causes:[4]
  • Heart failure
  • Aortic insufficiency
  • Septic shock
  • Vasoconstrictive drugs(e.g. Digoxin, alpha-adrenergic agonists)
  • Cocaine abuse/ergot poisoning
  • Hemodialysis

Less Common Risk Factors

  • Less common risk factors in the development of [disease name] include:
    • [Risk factor 1]
    • [Risk factor 2]
    • [Risk factor 3]

References

  1. 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.
  2. 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.
  3. 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.
  4. 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.

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References