Mesenteric Ischaemia Flashcards
What causes mesenteric ischaemia?
Lack of blood flow through mesenteric vessels causing intestinal ischaemia
What is the cause of chronic mesenteric ischaemia?
Narrowed mesenteric blood vessels due to atherosclerosis
Causes intermittent abdominal pain when blood supply unable to meet demand
What is the classic triad of chronic mesenteric ischaemia?
Central colicky abdominal pain after eating (30 minutes later, lasting 1-2 hours)
Weight loss
Abdominal bruit
What are the risk factors for chronic mesenteric ischaemia?
Age
Family history
Smoking
Diabetes
Hypertension
Raised cholesterol
How is mesenteric ischaemia diagnosed?
CT angiography
How is mesenteric ischaemia managed?
Reduce risk factors
Secondary prevention (statins and antiplatelets)
Revascularisation
How is revascularisation performed in mesenteric ischaemia?
Percutaneous mesenteric artery stenting
Open surgery e.g. endarterectomy
What is acute mesenteric ischaemia caused by?
Rapid blockage in the superior mesenteric artery caused by a thrombus or embolus
What is a key risk factor of acute mesenteric ischaemia?
Atrial fibrillation
How does acute mesenteric ischaemia present?
Acute, non-specific abdominal pain
Disproportionate to examination findings
Patient can develop shock, peritonitis and sepsis
Patient will have metabolic acidosis and raised lactate due to ischaemia
What diagnostic test is used for acute mesenteric ischaemia?
Contrast CT
Allows radiologist to look at bowel and blood supply
What is the purpose of surgery in acute mesenteric ischaemia?
Remove necrotic bowel
Remove or bypass thrombus in blood vessel
What is the mortality rate of acute mesenteric ischaemia?
50%
