Mesenteric ischemia causes: Difference between revisions

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==Overview==
==Overview==
Narrowing of the arteries that supply blood to the intestine causes mesenteric ischemia. The arteries that supply blood to the intestines run directly from the aorta. Mesenteric ischemia is often seen in people who have hardening of the arteries in other parts of the body (for example, those with coronary artery disease or peripheral vascular disease). The condition is more common in smokers and in patients with high blood pressure or blood cholesterol. Mesenteric ischemia may also be caused by an embolus that suddenly blocks one of the mesenteric arteries. The emboli usually come from the heart or aorta. These clots are more commonly seen in patients with arrhythmias, such as atrial fibrillation.  
Narrowing of the arteries that supply blood to the intestine causes [[Mesenteric ischemia|mesenteric]] ischemia. The arteries that supply blood to the [[Intestine|intestines]] travel straight from the [[aorta]]. [[Mesenteric ischemia|Mesenteric]] ischemia is often seen in people who have hardening of the arteries in other parts of the body (for example, those with [[Coronary heart disease|coronary artery disease]] or [[Peripheral arterial disease|peripheral vascular disease]]). The condition is more common in smokers and in patients with high blood pressure or high [[Blood cholesterol LDL and non-HDL treatment goals|blood cholesterol]]. Mesenteric ischemia can also be caused by an [[Embolism|embolus]] that suddenly blocks one of the mesenteric arteries. The [[Embolism|emboli]] usually come from the [[heart]] or [[aorta]]. These clots are more commonly seen in patients with [[Cardiac arrhythmia|arrhythmias]], such as [[atrial fibrillation]].
 
==Causes==
==Causes==
Mesenteric ischemia can be broadly classified into four categories:<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=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2194948  }} </ref><ref name="pmid19279432">{{cite journal| author=Di Fabio F, Obrand D, Satin R, Gordon PH| title=Intra-abdominal venous and arterial thromboembolism in inflammatory bowel disease. | journal=Dis Colon Rectum | year= 2009 | volume= 52 | issue= 2 | pages= 336-42 | pmid=19279432 | doi=10.1007/DCR.0b013e31819a235d | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19279432  }} </ref><ref name="pmid19491858">{{cite journal| author=Ha C, Magowan S, Accortt NA, Chen J, Stone CD| title=Risk of arterial thrombotic events in inflammatory bowel disease. | journal=Am J Gastroenterol | year= 2009 | volume= 104 | issue= 6 | pages= 1445-51 | pmid=19491858 | doi=10.1038/ajg.2009.81 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19491858  }} </ref><ref name="pmid25814200">{{cite journal| author=Stone JR, Wilkins LR| title=Acute mesenteric ischemia. | journal=Tech Vasc Interv Radiol | year= 2015 | volume= 18 | issue= 1 | pages= 24-30 | pmid=25814200 | doi=10.1053/j.tvir.2014.12.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25814200  }} </ref><ref name="pmid16476108">{{cite journal| author=Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M| title=Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors. | journal=J Intern Med | year= 2006 | volume= 259 | issue= 3 | pages= 305-13 | pmid=16476108 | doi=10.1111/j.1365-2796.2006.01613.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16476108  }} </ref>
Mesenteric ischemia is classified into four categories. Each category has their own cause:<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=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2194948  }} </ref><ref name="pmid19279432">{{cite journal| author=Di Fabio F, Obrand D, Satin R, Gordon PH| title=Intra-abdominal venous and arterial thromboembolism in inflammatory bowel disease. | journal=Dis Colon Rectum | year= 2009 | volume= 52 | issue= 2 | pages= 336-42 | pmid=19279432 | doi=10.1007/DCR.0b013e31819a235d | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19279432  }} </ref><ref name="pmid19491858">{{cite journal| author=Ha C, Magowan S, Accortt NA, Chen J, Stone CD| title=Risk of arterial thrombotic events in inflammatory bowel disease. | journal=Am J Gastroenterol | year= 2009 | volume= 104 | issue= 6 | pages= 1445-51 | pmid=19491858 | doi=10.1038/ajg.2009.81 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19491858  }} </ref><ref name="pmid25814200">{{cite journal| author=Stone JR, Wilkins LR| title=Acute mesenteric ischemia. | journal=Tech Vasc Interv Radiol | year= 2015 | volume= 18 | issue= 1 | pages= 24-30 | pmid=25814200 | doi=10.1053/j.tvir.2014.12.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25814200  }} </ref><ref name="pmid16476108">{{cite journal| author=Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M| title=Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors. | journal=J Intern Med | year= 2006 | volume= 259 | issue= 3 | pages= 305-13 | pmid=16476108 | doi=10.1111/j.1365-2796.2006.01613.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16476108 }} </ref><ref name="pmid15729076">{{cite journal| author=Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M| title=Clinical implications for the management of acute thromboembolic occlusion of the superior mesenteric artery: autopsy findings in 213 patients. | journal=Ann Surg | year= 2005 | volume= 241 | issue= 3 | pages= 516-22 | pmid=15729076 | doi= | pmc=1356992 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15729076  }} </ref><ref name="pmid25689121">{{cite journal| author=Acosta S| title=Mesenteric ischemia. | journal=Curr Opin Crit Care | year= 2015 | volume= 21 | issue= 2 | pages= 171-8 | pmid=25689121 | doi=10.1097/MCC.0000000000000189 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25689121  }} </ref><ref name="pmid22354487">{{cite journal| author=ter Steege RW, Sloterdijk HS, Geelkerken RH, Huisman AB, van der Palen J, Kolkman JJ| title=Splanchnic artery stenosis and abdominal complaints: clinical history is of limited value in detection of gastrointestinal ischemia. | journal=World J Surg | year= 2012 | volume= 36 | issue= 4 | pages= 793-9 | pmid=22354487 | doi=10.1007/s00268-012-1485-4 | pmc=3299959 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22354487  }} </ref><ref name="pmid18090993">{{cite journal| author=Otte JA, Huisman AB, Geelkerken RH, Kolkman JJ| title=Jejunal tonometry for the diagnosis of gastrointestinal ischemia. Feasibility, normal values and comparison of jejunal with gastric tonometry exercise testing. | journal=Eur J Gastroenterol Hepatol | year= 2008 | volume= 20 | issue= 1 | pages= 62-7 | pmid=18090993 | doi=10.1097/MEG.0b013e3282ef633a | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18090993  }} </ref><ref name="pmid29123896">{{cite journal| author=Uemura S, Suzuki K, Katayama N, Imai H| title=Superior mesenteric artery syndrome leading to reversible mucosal gangrene. | journal=Acute Med Surg | year= 2017 | volume= 4 | issue= 3 | pages= 375-376 | pmid=29123896 | doi=10.1002/ams2.283 | pmc=5674473 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29123896  }} </ref><ref name="pmid25979440">{{cite journal| author=Moore HB, Moore EE, Lawson PJ, Gonzalez E, Fragoso M, Morton AP et al.| title=Fibrinolysis shutdown phenotype masks changes in rodent coagulation in tissue injury versus hemorrhagic shock. | journal=Surgery | year= 2015 | volume= 158 | issue= 2 | pages= 386-92 | pmid=25979440 | doi=10.1016/j.surg.2015.04.008 | pmc=4492895 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25979440  }} </ref><ref name="pmid17768689 D">{{cite journal| author=Cohn DM, Roshani S, Middeldorp S| title=Thrombophilia and venous thromboembolism: implications for testing. | journal=Semin Thromb Hemost | year= 2007 | volume= 33 | issue= 6 | pages= 573-81 | pmid=17768689 D | doi=10.1055/s-2007-985753 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17768689  }} </ref><ref name="pmid18425546">{{cite journal| author=Aschoff AJ, Stuber G, Becker BW, Hoffmann MH, Schmitz BL, Schelzig H et al.| title=Evaluation of acute mesenteric ischemia: accuracy of biphasic mesenteric multi-detector CT angiography. | journal=Abdom Imaging | year= 2009 | volume= 34 | issue= 3 | pages= 345-57 | pmid=18425546 | doi=10.1007/s00261-008-9392-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18425546 }} </ref>
*[[Arterial thrombosis]]  
*[[Arterial thrombosis]]  
*[[Arterial embolism]]
*[[Arterial embolism]]
*[[Venous thrombosis]]
*[[Venous thrombosis]]
*[[Non-occlusive ischemia]]
*[[Non-occlusive ischemia]]
Venous thrombosis is more frequently seen in women and arterial thrombosis is more commonly seen in men.<ref name="pmid11407335">{{cite journal| author=Endean ED, Barnes SL, Kwolek CJ, Minion DJ, Schwarcz TH, Mentzer RM| title=Surgical management of thrombotic acute intestinal ischemia. | journal=Ann Surg | year= 2001 | volume= 233 | issue= 6 | pages= 801-8 | pmid=11407335 | doi= | pmc=1421323 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11407335  }} </ref>


{| class="wikitable"
{| class="wikitable"
! colspan="4" |Classification based on etiology
! colspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" |Classification based on etiology
|-
|-
!Etiology
! style="background:#4479BA; color: #FFFFFF;" | Etiology
!Cause
! style="background:#4479BA; color: #FFFFFF;" | Cause
!Incidence  
! style="background:#4479BA; color: #FFFFFF;" | Incidence  
!Examples
! style="background:#4479BA; color: #FFFFFF;" | Examples
! style="background:#4479BA; color: #FFFFFF;" | Mechanism
|-
|-
! rowspan="3" |Occlusive causes
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Occlusive causes
|Aterial embolism
|[[Embolism|Arterial embolism]]
|50-70%
|50-70%
|
|
* Superior mesenteric artery obstruction (most common cause)
* [[Superior mesenteric artery]] obstruction (most common cause)
* [[Arrhythmia]]
* [[Arrhythmia]]
* [[Myocardial infarction]]
* [[Myocardial infarction]]
Line 32: Line 33:
* [[Valvular heart disease|Valvular heart diseases]]
* [[Valvular heart disease|Valvular heart diseases]]
* [[Ventricular aneurysm|Ventricular aneurysms]]
* [[Ventricular aneurysm|Ventricular aneurysms]]
* History of embolic events
* History of [[embolic]] events
* Recent [[angiography]]  
* Recent [[angiography]]  
|
*'''[[Acute]] [[mesenteric]] arterial embolism''': Attributes to 50% cases of mesenteric ischemia.
*[[Mesenteric]] [[embolus]] can originate from the [[left atrium]], associated with [[Cardiac arrhythmia|cardiac arrythmia]]<nowiki/>s such as [[atrial fibrillation]].
*Recent [[myocardial infarction]] resulting in segmental wall motion abnormality leading to poor [[ejection fraction]] and [[Embolism|embolus]] formation.
*[[Infective endocarditis]]: vegetations on the cardiac valves resulting in turbulence in blood flow predisposing to formation of [[Embolism|emboli]] into the blood stream.
|-
|-
|Arterial thrombosis  
|[[Arterial thrombosis]]
|15-25%
|15-25%
|
|
* Atherosclerosis  
* [[Atherosclerosis]]
* Advanced age
* Advanced age
* Prolonged hypotension
* Prolonged [[hypotension]]
* [[Hypercoagulability|Hypercoagulabilty]] states
* [[Hypercoagulability|Hypercoagulabilty]] states
* [[Peripheral arterial disease]]
* [[Peripheral arterial disease]]
* Traumatic injury
* Traumatic injury
|
*'''Acute mesenteric arterial thrombosis''':
*25% cases of [[mesenteric ischemia]] result from mesenteric [[arterial thrombosis]].
*Most likely due to underlying [[atherosclerosis]](plaque formation) leading to stenosis.
*An underlying plaque(fatty streak) in the [[superior mesenteric artery]] leads to critical stenosis over the years forming collaterals.
|-
|-
|Venous thrombosis
|[[Venous thromboembolism|Venous thrombosis]]
|5%
|5%
|
|
* Right-sided heart failure
* Right-sided [[Congestive heart failure|heart failure]]
* Previous deep venous thrombosis (20-40% risk)
* Previous [[Deep vein thrombosis|deep venous thrombosis]] (20-40% risk)
* Primary clotting disorder
* Primary clotting disorder
* Pancreatitis
* [[Pancreatitis]]
* Polycythemia
* [[Polycythemia]]
* Sickle cell anemia
* [[Sickle-cell disease|Sickle cell anemia]]
* Recent abdominal surgery or infection
* Recent abdominal [[surgery]] or [[infection]]
* [[Visceral]] [[infections]]
* Perforated [[viscus]]
* [[Inherited]] [[thrombophilia]]-
**[[Factor V Leiden mutation|Factor V Leidin mutation]]
**[[Prothrombin G20210A mutation]]
**[[Protein S deficiency]]
 
**[[Antithrombin III deficiency]]
**[[Activated protein C resistance]]
**Anti-phospholipid syndrome
**[[Myeloproliferative neoplasm|Myeloproliferative disorders(JAK2 V617F) mutation.]]
|'''Mesenteric venous thrombosis:'''
* [[Thrombosis]] is attributed to the combination of [[Virchow's triad|virchow's]] triad:
** Stasis
** Vascular [[inflammation]]
** [[Hypercoagulability]]
|-
|-
|Non-Occlusive causes
! style="background:#4479BA; color: #FFFFFF;" |'''Non-Occlusive causes'''
|Non-occlusive ischemia
|[[Ischemia|Non-occlusive ischemia]]
|20-30%
|20-30%
|
|
* Low cardiac output states(most commom cause)
* Low [[cardiac output]] states(most common cause)
* Hypovolemia
* [[Hypovolemia]]
* Vasoconstrictive drugs (Digoxin, alpha-adrernergic agonists)
* [[Vasoconstrictive]] drugs ([[Digoxin]], alpha-adrenergic [[agonists]])
* Septic schock
* [[Sepsis|Septic shock]]
* Aortic insufficiency
* [[Aortic regurgitation|Aortic insufficiency]]
* Cocaine abuse or ergot poisoning
* [[Cocaine|Cocaine abuse]] or ergot poisoning
* Inflammatory bowel disease
* [[Inflammatory bowel disease]]
|}
|
 
* Occurs mainly because of [[superior mesenteric artery]] [[vasoconstriction]] leading to low [[splanchnic]] blood flow.  
*'''Acute mesenteric arterial embolism''': Attributes to 50% cases of mesenteric ischemia.<ref name="pmid25689121">{{cite journal| author=Acosta S| title=Mesenteric ischemia. | journal=Curr Opin Crit Care | year= 2015 | volume= 21 | issue= 2 | pages= 171-8 | pmid=25689121 | doi=10.1097/MCC.0000000000000189 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25689121  }} </ref><ref name="pmid15729076">{{cite journal| author=Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M| title=Clinical implications for the management of acute thromboembolic occlusion of the superior mesenteric artery: autopsy findings in 213 patients. | journal=Ann Surg | year= 2005 | volume= 241 | issue= 3 | pages= 516-22 | pmid=15729076 | doi= | pmc=1356992 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15729076  }} </ref>
*Mesenteric embolus can oringinate from the left atrium, associated with cardiac arrythmias such as atrial fibrillation.
*Recent myocardial infarction resulting in segmental wall motion abnormality leading to poor ejaction fraction and embolus formation.
*[[Infective endocarditis]]: vegetations on the cardiac valves resulting in turbulence in blood flow predisposing to formation of emboli into the blood stream.
*'''Acute mesenteric arterial thrombosis''':
*25% cases of mesenteric ischemia result from mesenteric arterial thrombosis.
*Most likely due to underlying atherosclerosis(plaque formation) leading to stenosis.
*An underlying plaque(fatty streak) in the superior mesenteric artery leads to critical stenosis over the years forming collaterals.
 
==Management of Patients With Peripheral Artery Disease (Compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations) : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines<ref name="pmid23473760">{{cite journal| author=Rooke TW, Hirsch AT, Misra S, Sidawy AN, Beckman JA, Findeiss L et al.| title=Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2013 | volume= 61 | issue= 14 | pages= 1555-70 | pmid=23473760 | doi=10.1016/j.jacc.2013.01.004 | pmc=4492473 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23473760  }} </ref>==
 
{| class="wikitable"
|-
|-
| colspan="1" style="text-align:center; background:LightGreen" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
! align="center" style="background:#4479BA; color: #FFFFFF;" |'''Rare causes'''
| colspan="4" |
* Splanchnic artery [[stenosis]]


|-
* [[Superior mesenteric artery syndrome]]
| bgcolor="LightGreen" | <nowiki>"</nowiki>'''1.'''  Nonocclusive intestinal ischemia should be suspected in patients with low flow states or shock, especially cardiogenic shock, who develop abdominal pain. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|}


|-
*
| bgcolor="LightGreen" | <nowiki>"</nowiki>'''2.''' Nonocclusive intestinal ischemia should be suspected in patients receiving vasoconstrictor substances and medications (e.g., cocaine, ergots, vasopressin, or norepinephrine) who develop abdominal pain. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
 
|-
| bgcolor="LightGreen" | <nowiki>"</nowiki>'''3.''' Nonocclusive intestinal ischemia should be suspected in patients who develop abdominal pain after coarctation repair or after surgical revascularization for intestinal ischemia caused by arterial obstruction. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|}


==References==
==References==
Line 99: Line 111:


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Narrowing of the arteries that supply blood to the intestine causes mesenteric ischemia. The arteries that supply blood to the intestines travel straight from the aorta. Mesenteric ischemia is often seen in people who have hardening of the arteries in other parts of the body (for example, those with coronary artery disease or peripheral vascular disease). The condition is more common in smokers and in patients with high blood pressure or high blood cholesterol. Mesenteric ischemia can also be caused by an embolus that suddenly blocks one of the mesenteric arteries. The emboli usually come from the heart or aorta. These clots are more commonly seen in patients with arrhythmias, such as atrial fibrillation.

Causes

Mesenteric ischemia is classified into four categories. Each category has their own cause:[1][2][3][4][5][6][7][8][9][10][11][12][13]

Classification based on etiology
Etiology Cause Incidence Examples Mechanism
Occlusive causes Arterial embolism 50-70%
Arterial thrombosis 15-25%
Venous thrombosis 5% Mesenteric venous thrombosis:
Non-Occlusive causes Non-occlusive ischemia 20-30%
Rare causes

References

  1. ↑ Reinus JF, Brandt LJ, Boley SJ (1990). "Ischemic diseases of the bowel". Gastroenterol Clin North Am. 19 (2): 319–43. PMID 2194948.
  2. ↑ Di Fabio F, Obrand D, Satin R, Gordon PH (2009). "Intra-abdominal venous and arterial thromboembolism in inflammatory bowel disease". Dis Colon Rectum. 52 (2): 336–42. doi:10.1007/DCR.0b013e31819a235d. PMID 19279432.
  3. ↑ Ha C, Magowan S, Accortt NA, Chen J, Stone CD (2009). "Risk of arterial thrombotic events in inflammatory bowel disease". Am J Gastroenterol. 104 (6): 1445–51. doi:10.1038/ajg.2009.81. PMID 19491858.
  4. ↑ Stone JR, Wilkins LR (2015). "Acute mesenteric ischemia". Tech Vasc Interv Radiol. 18 (1): 24–30. doi:10.1053/j.tvir.2014.12.004. PMID 25814200.
  5. ↑ Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M (2006). "Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors". J Intern Med. 259 (3): 305–13. doi:10.1111/j.1365-2796.2006.01613.x. PMID 16476108.
  6. ↑ Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M (2005). "Clinical implications for the management of acute thromboembolic occlusion of the superior mesenteric artery: autopsy findings in 213 patients". Ann Surg. 241 (3): 516–22. PMC 1356992. PMID 15729076.
  7. ↑ Acosta S (2015). "Mesenteric ischemia". Curr Opin Crit Care. 21 (2): 171–8. doi:10.1097/MCC.0000000000000189. PMID 25689121.
  8. ↑ ter Steege RW, Sloterdijk HS, Geelkerken RH, Huisman AB, van der Palen J, Kolkman JJ (2012). "Splanchnic artery stenosis and abdominal complaints: clinical history is of limited value in detection of gastrointestinal ischemia". World J Surg. 36 (4): 793–9. doi:10.1007/s00268-012-1485-4. PMC 3299959. PMID 22354487.
  9. ↑ Otte JA, Huisman AB, Geelkerken RH, Kolkman JJ (2008). "Jejunal tonometry for the diagnosis of gastrointestinal ischemia. Feasibility, normal values and comparison of jejunal with gastric tonometry exercise testing". Eur J Gastroenterol Hepatol. 20 (1): 62–7. doi:10.1097/MEG.0b013e3282ef633a. PMID 18090993.
  10. ↑ Uemura S, Suzuki K, Katayama N, Imai H (2017). "Superior mesenteric artery syndrome leading to reversible mucosal gangrene". Acute Med Surg. 4 (3): 375–376. doi:10.1002/ams2.283. PMC 5674473. PMID 29123896.
  11. ↑ Moore HB, Moore EE, Lawson PJ, Gonzalez E, Fragoso M, Morton AP; et al. (2015). "Fibrinolysis shutdown phenotype masks changes in rodent coagulation in tissue injury versus hemorrhagic shock". Surgery. 158 (2): 386–92. doi:10.1016/j.surg.2015.04.008. PMC 4492895. PMID 25979440.
  12. ↑ Cohn DM, Roshani S, Middeldorp S (2007). "Thrombophilia and venous thromboembolism: implications for testing". Semin Thromb Hemost. 33 (6): 573–81. doi:10.1055/s-2007-985753. PMID D 17768689 D Check |pmid= value (help).
  13. ↑ Aschoff AJ, Stuber G, Becker BW, Hoffmann MH, Schmitz BL, Schelzig H; et al. (2009). "Evaluation of acute mesenteric ischemia: accuracy of biphasic mesenteric multi-detector CT angiography". Abdom Imaging. 34 (3): 345–57. doi:10.1007/s00261-008-9392-8. PMID 18425546.
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