Acute mesenteric ischemia causes: Difference between revisions

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__NOTOC__
__NOTOC__
{{CMG}}; {{AE}} [[User:Rim Halaby|Rim Halaby]]
{{CMG}}; {{AE}} [[User:Rim Halaby|Rim Halaby]]
{{Acute mesenteric ischemia}}


==Overview==
==Overview==
[[Acute mesenteric ischemia]] is caused in 50% of the cases by an [[embolism]] in the arterial mesenteric vasculature and in 30 % of the cases by a thrombus. 5% of the cases of acute mesenteric ischemia are caused by venous occlusion due to [[hypercoagulable]] state. In 20 to 30% of the cases, acute mesenteric ischemia is non occlusive and is rather caused by decreased systemic perfusion in the setting of an elderly patients with multiple co-morbidities and under treatment with medications that affect the effective circulatory volume such as [[diuretics]].<ref name="klar">Klar E, Rahmanian PB, Bücker A, Hauenstein K, Jauch KW, Luther B: Acute mesenteric ischemia: a vascular emergency. Dtsch Arztebl Int 2012; 109(14): 249–56. DOI: 10.3238/arztebl.2012.0249</ref><ref name="pmid2194948">{{cite journal| author=Reinus JF, Brandt LJ, Boley SJ| title=Ischemic diseases of the bowel. | journal=Gastroenterol Clin North Am | year= 1990 | volume= 19 | issue= 2 | pages= 319-43 | pmid=2194948 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2194948  }} </ref><ref name="pmid9146713">{{cite journal| author=Rosenblum JD, Boyle CM, Schwartz LB| title=The mesenteric circulation. Anatomy and physiology. | journal=Surg Clin North Am | year= 1997 | volume= 77 | issue= 2 | pages= 289-306 | pmid=9146713 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9146713  }} </ref>
[[Acute mesenteric ischemia]] is caused in 50% of the cases by an [[embolism]] in the arterial mesenteric vasculature and in 30 % of the cases by a thrombus. 5% of the cases of [[acute mesenteric ischemia]] are caused by venous occlusion due to [[hypercoagulable]] state. In 20 to 30% of the cases, acute mesenteric ischemia is non occlusive and is caused by decreased systemic perfusion in the setting of an elderly patients with multiple co-morbidities and under treatment with medications that affect the effective circulatory volume such as [[diuretics]].<ref name="klar">Klar E, Rahmanian PB, Bücker A, Hauenstein K, Jauch KW, Luther B: Acute mesenteric ischemia: a vascular emergency. Dtsch Arztebl Int 2012; 109(14): 249–56. DOI: 10.3238/arztebl.2012.0249</ref><ref name="pmid2194948">{{cite journal| author=Reinus JF, Brandt LJ, Boley SJ| title=Ischemic diseases of the bowel. | journal=Gastroenterol Clin North Am | year= 1990 | volume= 19 | issue= 2 | pages= 319-43 | pmid=2194948 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2194948  }} </ref><ref name="pmid9146713">{{cite journal| author=Rosenblum JD, Boyle CM, Schwartz LB| title=The mesenteric circulation. Anatomy and physiology. | journal=Surg Clin North Am | year= 1997 | volume= 77 | issue= 2 | pages= 289-306 | pmid=9146713 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9146713  }} </ref>


==Causes==
==Causes==
===Occlusive Arterial Acute Mesenteric Ischemia (65-75%)===
===Occlusive Arterial Acute Mesenteric Ischemia (65-75%)===
* [[Embolism]] (50%)
* [[Embolism]] (50%)<ref name="klar">Klar E, Rahmanian PB, Bücker A, Hauenstein K, Jauch KW, Luther B: Acute mesenteric ischemia: a vascular emergency. Dtsch Arztebl Int 2012; 109(14): 249–56. DOI: 10.3238/arztebl.2012.0249</ref>
**[[Atrial fibrillation]]
**[[Atrial fibrillation]]
**[[Heart failure]]
**[[Heart failure]]
**[[CAD]]
**[[CAD]]
* [[Thrombus]] (15-25%)
* [[Thrombus]] (15-25%)<ref name="klar">Klar E, Rahmanian PB, Bücker A, Hauenstein K, Jauch KW, Luther B: Acute mesenteric ischemia: a vascular emergency. Dtsch Arztebl Int 2012; 109(14): 249–56. DOI: 10.3238/arztebl.2012.0249</ref>
** [[Atherosclerosis]]
** [[Atherosclerosis]]
** [[Infection]]
** [[Infection]]
** [[Trauma]]
** [[Trauma]]<ref name="Hag">Haglund U. Mesenteric ischemia. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001.  Available from: http://www.ncbi.nlm.nih.gov/books/NBK6883/</ref>
*[[Strangulation]]<ref name="Hag">Haglund U. Mesenteric ischemia. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001.  Available from: http://www.ncbi.nlm.nih.gov/books/NBK6883/</ref>
* [[Vasculitis]]<ref name="Hag">Haglund U. Mesenteric ischemia. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001.  Available from: http://www.ncbi.nlm.nih.gov/books/NBK6883/</ref>


===Occlusive Venous Acute Mesenteric Ischemia (5%)===
===Occlusive Venous Acute Mesenteric Ischemia (5%)===
* [[Hypercoagulable|Inherited hypercoagulability]]
* [[Hypercoagulable|Inherited hypercoagulability]]
** [[Factor V Laden]]
** [[Prothrombin]] gene mutation
** [[Antithrombin III]] deficiency
** [[Protein C]] deficiency
** [[Protein S]] deficiency
* [[Malignancy]]
* [[Malignancy]]
* [[Pancreatitis]]
* [[Pancreatitis]]
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Disease]]
[[Category: Up-To-Date]]
[[Category:Mature chapter]]
[[Category:Surgery]]
[[Category:Overview complete]]
[[Category:Template complete]]

Latest revision as of 21:07, 12 December 2012

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby

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Overview

Acute mesenteric ischemia is caused in 50% of the cases by an embolism in the arterial mesenteric vasculature and in 30 % of the cases by a thrombus. 5% of the cases of acute mesenteric ischemia are caused by venous occlusion due to hypercoagulable state. In 20 to 30% of the cases, acute mesenteric ischemia is non occlusive and is caused by decreased systemic perfusion in the setting of an elderly patients with multiple co-morbidities and under treatment with medications that affect the effective circulatory volume such as diuretics.[1][2][3]

Causes

Occlusive Arterial Acute Mesenteric Ischemia (65-75%)

Occlusive Venous Acute Mesenteric Ischemia (5%)

Non Occlusive Mesenteric Ischemia (20-30%)

References

  1. ↑ 1.0 1.1 1.2 1.3 Klar E, Rahmanian PB, Bücker A, Hauenstein K, Jauch KW, Luther B: Acute mesenteric ischemia: a vascular emergency. Dtsch Arztebl Int 2012; 109(14): 249–56. DOI: 10.3238/arztebl.2012.0249
  2. ↑ 2.0 2.1 Reinus JF, Brandt LJ, Boley SJ (1990). "Ischemic diseases of the bowel". Gastroenterol Clin North Am. 19 (2): 319–43. PMID 2194948.
  3. ↑ 3.0 3.1 Rosenblum JD, Boyle CM, Schwartz LB (1997). "The mesenteric circulation. Anatomy and physiology". Surg Clin North Am. 77 (2): 289–306. PMID 9146713.
  4. ↑ 4.0 4.1 4.2 Haglund U. Mesenteric ischemia. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001. Available from: http://www.ncbi.nlm.nih.gov/books/NBK6883/
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