Mesenteric Ischaemia Flashcards
What is the most common mechanismsofabruptocclusion inacute mesenteric ischaemia?
Arterial Emboli(most common):
* Sudden onset
* Stereotypically a patient withAF(irregular pulse on exam)
* Other causes include: post-MI, septic emboli, valvular disease
What is the cause of arterial thrombi in mesenteric ischaemia?
- Sudden onset
- Atherosclerosis progressing into a thrombus formation that occludes the artery (typically SMA)
What is the cause of non-occlusive Mesenteric ischaemia?
- significant ↓ hypoperfusion
- Caused by severe hypotension (critically ill)
- Also caused by: vasopressors, digitalis, cocaine
What is the cause of mesenteric enough thrombosis?
Least common * Typically associated with hypercoagulability
Which vessel is commonly affected in AMI?
Superior mesenteric artery arises from abdomianl aorta at asteep angle, furthermore, haspoor collateral perfusionthus making it vulnerable. There is poor prognosis.
What layers of bowel are affected in acute mesenteric ischaemia?
All layers
What is the presentation of mesenteric ischaemia?
Vomiting and sudden severe abdominal pain
What is the presentation of ischaemic colitis?
Diarrhoea and crampy lower abomdinal pain
When is Triple A managed with surgery?
Over 5.5cm unless:
Aneurysm has enlarged 1cm or more in a year
What is a medium aneurysm management?
It is 4.5 to 5.4 and rescan every 3 months
What is the management of small aneurysm?
3 to 4.4cm and it is a small aneurysm whic is rescanned every 1 months
What is a small aneurysm?
Less than 3cm
