acute small bowel ischaemia

Question 1

what is acute small bowel ischaemia?

Answer 1

-lack of oxygenated blood to small bowel following superior mesenteric artery occlusion or non occlusive perfusion insufficiency

Question 2

causes?

Answer 2

• thrombosis/embolism to superior mesenteric artery or vein
• trauma
• hypoperfusion due to hypotension following an MI
• shock
• hypovolaemia
• heart failure

Question 3

what are symptoms of acute small bowel ischemia?

Answer 3

• severe central/RIF abdominal pain
• silent and distended abdomen
• no. minimal abdominal signs
• rapid hypovolaemia leading to shock

Question 4

investigations for acute small bowel ischemia?

Answer 4

• CT angiogram

- AXR (thumb printing of mucosa)

Question 5

management of acute small bowel ischamia?

Answer 5

• resus with fluids
• LMWH/heparin
• urgent surgery with resection of non viable intestines/ revascularisation on potentially viable bowel

Question 6

signs of acute small bowel ischamia?

Answer 6

• increase WBC
• increase lactate
• metabolic acidosis