Mesenteric Ischemia Flashcards
arterial etiology + venous
celiar artery, superior mesenteric artery (SMA(, inferior mesenteric artery
superior mesenteric vein thrombosis
*Cause is usually SMA occlusion (embolus/thrombus)
Risks:
Hypercoagulable states, AF, ASHD
Cause: Embolism or thrombus
Presentation:
Sudden onset of severe pain.
Diarrhea that becomes rapidly bloody
Occurs in the small bowel
Exam may be unremarkable-Reported Pain out of proportion to exam
Abnormal labs in mesenteric ischemia
Increased lactate
Increased WBC
Metabolic acidosis
what is the gold standard diagnostic for this mesenteric ischemia
CT Angio
Treatment of acute mesenteric ischemia
embolectomy
chronic mesenteric ischemia presentation
Post prandial epigastric pain, typically after meals due to increased vascular demand
-Dull Pain
-Fear of eatingweight loss
complications of chronic mesenteric ischemia
-Bowel necrosis and perforation
Risk factors associated with chronic mesenteric ischemic
-Smoking, DM, ASHD, older than age 60
management of chronic mesenteric ischemia
Optimizing risk factors
Smoking cessation
BP control
Endovascular treatments such as stentint
what is affected in ischemic colitis
Large bowel/Colon is affected
Presentation is ischemia colitis
acutely severe pain, bloody diarrhea
Caused by hypoperfusion to the large bowel
gold standard for diagnosing Ischemic colitis
colonoscopy
Treatment for ischemic colitis
Supportive, hydrate, support BP
NPO
broad spectrum abx
Signs of colonic infarction
-Thumbprinting of the bowel lumen on imaging (bowel wall edema),
pneumatosis
