Acute Mesenteric Ischaemia

Question 1

Blood supply to the gut

Answer 1

• Foregut
  
  • Stomach to 3^rd part of the duodenum, biliary system, liver and pancreas
  • Celiac artery
  • Epigastric pain
• Midgut
  
  • 4^th part of duodenum to transverse colon
  • Superior mesenteric artery
  • Umbilical pain
• Hindgut
  
  • Transverse colon to rectum
  • Inferior mesenteric artery
  • Hypogastric pain

Question 2

Risk factors

Answer 2

• Older age
• AF
• Atherosclerosis
• Coagulation disorders

Question 3

Diagnosis and management

Answer 3

• Blood lactate raised
• Diagnose with CT angiogram
• Ultimately results in gangrene +/- perforation
• Managed by fluid resuscitation, thrombolysis and surgical intervention
• Very poor prognosis