Ischemic gut injury

Question 1

Acute small bowel ischemia
which vessels involved most
features

Answer 1

superior mesenteric artery

abdominal pain
distended bowel
diminished bowel sounds
peritonitis

Question 2

acute small bowel ischemia
investigation
findings

Answer 2

plain x ray abdomen
thumb printing

gold standard: CT with contrast

Question 3

Rx of acute small bowel ischemia

Answer 3

Resuscitation
IV antibiotics
rx of cardiac cause
embolectomy and vascular reconstruction
thrombolysis or percutaneous transluminal angioplasty
small bowel transplantation

Question 4

chronic mesenteric ischemia
SS
✳️investigation
Rx

Answer 4

dull but severe mid or upper abdominal pain about 30 mins after eating
abdominal bruit

mesenteric angiography

Rx: vascular reconstruction, percutaneous angioplasty and stenting