Description

Mesenteric ischemia (mez-un-TER-ik is-KEE-me-uh) is a condition that occurs when narrowed or blocked arteries restrict blood flow to the small intestine. The decreased blood flow may cause permanent damage to the small intestine.

Sudden loss of blood flow to the small intestine is called acute mesenteric ischemia. The acute type is often caused by a blood clot and requires immediate treatment, such as surgery.

Mesenteric ischemia that develops over time is called chronic mesenteric ischemia. The chronic type is usually caused by a buildup of fatty deposits in the arteries. Chronic mesenteric ischemia is treated with open surgery or a procedure called angioplasty.

Chronic mesenteric ischemia can be severe if not treated. It can also lead to severe weight loss and malnutrition.

Symptoms

Acute mesenteric ischemia

The symptoms of the acute form of mesenteric ischemia include:

  • Sudden, severe abdominal pain.
  • Urgent need to have a bowel movement.
  • Fever.
  • Nausea and vomiting.

Chronic mesenteric ischemia

The symptoms of the chronic form of mesenteric ischemia include:

  • Abdominal pain that begins about 30 minutes after eating.
  • Pain that worsens over an hour.
  • Pain that goes away within 1 to 3 hours.

When to see a doctor

If you have sudden and severe stomach pain, pain that persists, seek emergency medical attention. If you develop pain after eating, make an appointment with your primary care provider.

Causes

Both acute and chronic mesenteric ischemia is caused by a decrease in blood flow to the small intestine. Acute mesenteric ischemia is most commonly caused by a blood clot in the main mesenteric artery. The blood clot that often begins in the heart. The chronic form is more commonly caused by a buildup of fatty deposits, called plaque, which narrows the arteries.

Risk factors

The most common risk factors for acute mesenteric ischemia include:

  • Atrial fibrillation-an irregular and often rapid heart rhythm.
  • Congestive heart failure — a condition in which the heart muscle does not pump blood as well as it should.
  • Recent vascular surgery.

The most common risk factors for chronic mesenteric ischemia include:

  • Type 2 diabetes.
  • High levels of cholesterol.
  • The high blood pressure.
  • Artery disease.
  • The habit of smoking.
  • Obesity.
  • Advanced age.

Complications

If not treated promptly, acute mesenteric ischemia can lead to:

  • Irreversible intestinal damage. It does not receive enough blood flow to the bowel can cause parts of the bowel to die.
  • Sepsis. This life-threatening condition caused by the body releasing chemicals into the bloodstream to fight the infection. In sepsis, the body overreacts to the chemicals, causing changes that can lead to multiple organ failure.
  • Death. Both complications can lead to death.

People with chronic mesenteric ischemia may develop:

  • Fear of eating. This happens because after eating, the pain associated with the disease.
  • The loss of weight is not the intention. This can occur as a result of the fear of eating.
  • Acute-on-chronic mesenteric ischemia. The symptoms of chronic mesenteric ischemia can be worse, which leads to the acute form of the disease.

Diagnosis

If you have pain after eating that makes you to limit foods and lose weight, your doctor may suspect that you have a chronic mesenteric ischemia. A narrowing of the major arteries to the small intestine may help to confirm the diagnosis.

Tests may include:

  • The angiography. Your health care provider may recommend a ct scan, mri, X-ray of your abdomen to find out if the arteries of the small intestine that have narrowed. The addition of a contrast dye may help to identify the areas where the arteries have narrowed.
  • The Doppler ultrasound. This non-invasive test that uses sound waves to check the flow of blood, which can determine the narrowing of the arteries.

Treatment

If a blood clot causes a sudden loss of blood flow to the small intestine, which may require immediate surgery for the treatment of mesenteric ischemia.

Mesenteric ischemia that develops over time can be treated with angioplasty. Angioplasty is a procedure that uses a balloon to open the narrowed area. A mesh tube called a stent can be placed in the narrow area.

Mesenteric ischemia can also be treated by open surgery through an incision.

Symptoms and treatment of Mesenteric ischemia