Bowel ischaemia

Question 1

Contrast cause of types of bowel ischaemia

Answer 1

Acute mesenteric: embolism in superior mesenteric artery
Chronic mesenteric: atherosclerosis
Colonic: poor inferior mesenteric artery flow

Question 2

Contrast pain in types of bowel ischaemia

Answer 2

Acute mesenteric: sudden, severe pain disproportionate to clinical exam
Chronic mesenteric: intermittent, colicky pain
Colonic: onset over few hours, localised tenderness

Question 3

Contrast associated symptoms in types of bowel ischaemia

Answer 3

Acute mesenteric: none
Chronic mesenteric: malabsorption, PR bleed, N+V
Colonic: bloody diarrhoea

Question 4

Contrast management of types of bowel ischaemia

Answer 4

Acute mesenteric: laparotomy to remove necrotic bowel
Chronic mesenteric: elective angioplasty and stenting to reduce risk of acute mesenteric ischaemia
Colonic: conservative - fluids, antibiotics and anticoagulation