Sandbox:Feham

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

Overview

Mesenteric ischemia is a type of intestinal ischemia primarily affecting the small intestine. It is one of the life-threatening gastrointestinal vascular emergencies which requires prompt surgical/medical intervention depending upon the underlying cause.

Common causes in the development of mesenteric ischemia can be divided into occlusive/non-occlusive, arterial or venous, localized/generalized and superficial or transmural.

Risk Factors

• Mesenteric ischemia can be caused by any factor that can compromise the blood supply to the affected organ; either by reducing the perfusion( low blood pressure or vasoconstriction) or by promoting the formation of thromboemboli(blood clots). It can be broadly classified as modifiable and non-modifiable.

Common Risk Factors

Risk factors
Occlusive	Embolic	Atrial fibrillation
		Cardiac arrhythmia
		Valvular heart disease
		Infective endocarditis
		Recent myocardial infarction
		Ventricular aneurysm
		Aortic atherosclerosis
		Aortic aneurysm
	Thrombotic	Advanced age
		Low cardiac output states
		Peripheral arterial disease
		Traumatic injury
		Inherited thrombophilia- Factor V Leidin mutation Prothrombin G20210A mutation Protein S deficiency Antithrombin III deficiency Activated protein C resistance Anti-phospholipid syndrome Myeloproliferative disorders(JAK2 V617F) mutation.
		Acquired thrombophilia- malignancy, oral contraceptives intake.
Non-occlusive		Heart failure
		Aortic insufficiency
		Septic shock
		Vasoconstrictive drugs: Digoxin Alpha-adrenergic agonists
		Cocaine abuse or ergot poisoning
		Hemodialysis

• Common risk factors in the development of mesenteric ischemia include:
  • Non-modifiable causes**
    • Age >60 years
    • High cholesterol levels
    • History of smoking
  • Occlusive causes
    • Embolic causes:
    • Atrial fibrillation
    • Cardiac arrhythmias
    • Valvular heart diseases
    • Infective endocarditis
    • Recent myocardial infarction
    • Ventricular aneurysm
    • Aortic atherosclerosis
    • Aortic aneurysm
  • Thrombotic causes:
    • Advanced age
    • Low cardiac output states
    • Traumatic injury
    • Peripheral artery disease
• Non-occlusive causes:
  • Heart failure
  • Aortic insufficiency
  • Septic shock
  • Vasoconstrictive drugs(e.g. Digoxin, alpha-adrenergic agonists)
  • Cocaine abuse/ergot poisoning
  • Hemodialysis

Less Common Risk Factors

• Less common risk factors in the development of [disease name] include:
  • [Risk factor 1]
  • [Risk factor 2]
  • [Risk factor 3]

Causes

Disease name] may be caused by [cause1], [cause2], or [cause3].

OR

Common causes of [disease] include [cause1], [cause2], and [cause3].

OR

The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].

OR

The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.

Causes[edit | edit source] Life-threatening Causes[edit | edit source] Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. There are no life-threatening causes of disease name, however complications resulting from untreated disease name is common. Life-threatening causes of [symptom/manifestation] include [cause1], [cause2], and [cause3]. [Cause] is a life-threatening cause of [disease]. Common Causes[edit | edit source] [Disease name] may be caused by:

[Cause1] [Cause2] [Cause3]

OR

[Disease name] is caused by an infection with [pathogen name]. [Pathogen name] is caused by [pathogen name]. Less Common Causes[edit | edit source] Less common causes of disease name include:

[Cause1] [Cause2] [Cause3] Genetic Causes[edit | edit source] [Disease name] is caused by a mutation in the [gene name] gene.