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Question 1

Types mesentric vascular insufficiency

Answer 1

(1) arterioocclusive mesenteric ischemia, (2) nonocclusive mesenteric ischemia, and (3) mesenteric venous thrombosis.

Question 2

Causes /risk factors for mesentric vascular ischemia

Answer 2

ARTERIOOCCLUSIVE:emnoli/thrombus
atrial fib
Recent MI
Valvular heart ds
Recent cardiac or vascular catheterisation

NONOCCLUSIVE/intestinal angina
Aging:artherosclerosis
High dose vasopressors infusions
Cardiogenic or septic shock

VENOUS THROMBOSIS:hypercoaguable state
Protein C /S def
Anti thrombin III def
Polycythemia  vera
Carcinoma

Question 3

Most common locations for intestinal ischemia

Answer 3

. Collateral vessels within the small bowel are numerous and meet within the duodenum and the bed of the pancreas. Collateral vessels within the colon meet at the splenic flexure and descending/sigmoid colon. These areas, which are inherently at risk for decreased blood flow, are known as Griffiths’ point and Sudeck’s point, respectively, and are the most common locations for colonic ischemia

Question 4

Clinical Features in acute mesentric ischemia

Answer 4

Acute abd pain
Vomiting
Transient diarrhoa
Anorexia bloody stools
Abd distenstion
Late:peritonitis

Question 5

Thumbprinting

Answer 5

Earlier features of intestinal ischemia seen on abdominal radiographs include bowel-wall edema, known as “thumbprinting.” If the ischemia progresses, air can be seen within the bowel wall (pneumatosis intestinalis) and within the portal venous system.

Question 6

Gold standard for Dx for acute and chronic mesentric ischemia

Answer 6

Angiography

For venous thrombosis(venous phase also)

Question 7

Triad of chronic intestinal ischemia

Answer 7

Abdominal pain
Food phobia
Weight loss(very imp)