Mesenteric ischemia history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
The hallmark of mesenteric ischemia symptoms is 'abdominal pain out of proportion to the examination findings'. A positive history of chronic cardiovascular disorder, old age and abdominal pain is suggestive of mesenteric ischemia . The most common symptoms of mesenteric ischemia include excruciating abdominal pain, bloody diarrhea, and nausea/vomiting. Symptoms of chronic mesenteric ischemia caused by [[atherosclerosis]] include abdominal pain after eating and diarrhea, while that of acute mesenteric artery ischemia due to an embolus include diarrhea, sudden severe abdominal pain, and vomiting. | The hallmark of [[mesenteric ischemia]] symptoms is '[[abdominal pain]] out of proportion to the examination findings'. A positive history of chronic cardiovascular disorder, old age and abdominal pain is suggestive of mesenteric ischemia . The most common symptoms of [[mesenteric ischemia]] include excruciating abdominal pain, [[Dysentery|bloody diarrhea]], and nausea/[[Nausea and vomiting|vomiting]]. Symptoms of chronic mesenteric ischemia caused by [[atherosclerosis]] include abdominal pain after eating and diarrhea, while that of acute mesenteric artery ischemia due to an [[Embolism|embolus]] include diarrhea, sudden severe abdominal pain, and [[Nausea and vomiting|vomiting]]. | ||
==History== | ==History== | ||
| Line 21: | Line 21: | ||
* | * | ||
| | | | ||
* Coronary heart disease | * [[Coronary heart disease]] | ||
* Cerebrovascular disease | * [[Cerebrovascular disease]] | ||
* Vasculitis | * [[Vasculitis]] | ||
* Peripheral artery disease | * [[Peripheral arterial disease|Peripheral artery disease]] | ||
* Irregular cardiac rythm disorders | * Irregular cardiac rythm disorders | ||
such as atrial fibrillation | such as atrial fibrillation | ||
* Malignancy | * Malignancy | ||
* Chronic liver disease | * Chronic liver disease | ||
* Portal vein thrombosis | * [[Portal vein thrombosis]] | ||
* Inflammatory disease | * [[Inflammation|Inflammatory disease]] | ||
* Thrombophilia | * [[Thrombophilia]] | ||
* Inflammatory bowel disease | * [[Inflammatory bowel disease]] | ||
| | | | ||
* Recent abdominal surgery | * Recent abdominal surgery | ||
* | * | ||
|Family history of | |Family history of | ||
* Deep venous thrombosis | * [[Deep vein thrombosis|Deep venous thrombosis]] | ||
* Pulmonary embolism | * [[Pulmonary embolism]] | ||
* Myeloproliferative disorders | * [[Myeloproliferative neoplasm|Myeloproliferative disorders]] | ||
|} | |} | ||
==Symptoms== | ==Symptoms== | ||
The severity and rapidity of mesenteric vessels occlusion determine the symptoms of mesenteric ischemia. <ref name="pmid15159262">{{cite journal |author=Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD |title=Acute mesenteric ischemia: a clinical review |journal=Arch. Intern. Med. |volume=164 |issue=10 |pages=1054-62 |year=2004 |pmid=15159262 | doi=10.1001/archinte.164.10.1054}}</ref><ref name="pmid2691119">{{cite journal |author=Font VE, Hermann RE, Longworth DL |title=Chronic mesenteric venous thrombosis: difficult diagnosis and therapy |journal=Cleveland Clinic journal of medicine |volume=56 |issue=8 |pages=823-8 |year=1989 |pmid=2691119}}</ref> | The severity and rapidity of mesenteric vessels occlusion determine the symptoms of [[mesenteric ischemia]]. <ref name="pmid15159262">{{cite journal |author=Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD |title=Acute mesenteric ischemia: a clinical review |journal=Arch. Intern. Med. |volume=164 |issue=10 |pages=1054-62 |year=2004 |pmid=15159262 | doi=10.1001/archinte.164.10.1054}}</ref><ref name="pmid2691119">{{cite journal |author=Font VE, Hermann RE, Longworth DL |title=Chronic mesenteric venous thrombosis: difficult diagnosis and therapy |journal=Cleveland Clinic journal of medicine |volume=56 |issue=8 |pages=823-8 |year=1989 |pmid=2691119}}</ref> | ||
Systemic classification of acute and chronic mesenteric ischemia symptoms is as follows: | Systemic classification of acute and chronic [[mesenteric ischemia]] symptoms is as follows: | ||
{| class="wikitable" | {| class="wikitable" | ||
| Line 64: | Line 64: | ||
* [[Heart rate]] > 100 in 33% | * [[Heart rate]] > 100 in 33% | ||
| | | | ||
* '''Abdominal Pain:'''(present in 95% cases) | * '''[[Abdominal pain|Abdominal]] Pain:'''(present in 95% cases) | ||
* Site: Periumbilical. Focal pain in case of bowel necrosis. | * Site: Periumbilical. Focal pain in case of bowel necrosis. | ||
| Line 81: | Line 81: | ||
'''Other associations:''' | '''Other associations:''' | ||
* Urgency to bowel movements | * Urgency to bowel movements | ||
* Vomiting (35%) | * [[Nausea and vomiting|Vomiting]] (35%) | ||
* Diarrhea (35%) | * [[Diarrhea]] (35%) | ||
* Constipation | * [[Constipation]] | ||
* Blood per rectum | * Blood per rectum | ||
* Abdominal distention | * [[Abdominal distension|Abdominal distention]] | ||
* Increased frequency of bowel movements | * Increased frequency of bowel movements | ||
|'''Signs of shock:''' | |'''Signs of shock:''' | ||
* Palpitations | * [[Palpitation|Palpitations]] | ||
* Low blood pressure | * Low [[blood pressure]] | ||
* Altered mental status | * [[Altered mental status]] | ||
* Shortness of breath | * [[Dyspnea|Shortness of breath]] | ||
| | | | ||
* Nausea | * [[Nausea and vomiting|Nausea]] | ||
* Bloating | * [[Bloating]] | ||
| | | | ||
* '''Abdominal pain:''' | * '''[[Abdominal pain|Abdominal]] pain:''' | ||
* Site: Poorly localised | * Site: Poorly localised | ||
| Line 113: | Line 113: | ||
* Worsening abdominal pain | * Worsening abdominal pain | ||
* Aversion to eating | * Aversion to eating | ||
* Unintentional weight loss | * Unintentional [[Weight loss|weight]] loss | ||
* Diarrhea | * [[Diarrhea]] | ||
|} | |} | ||
Revision as of 04:14, 8 January 2018
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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
The hallmark of mesenteric ischemia symptoms is 'abdominal pain out of proportion to the examination findings'. A positive history of chronic cardiovascular disorder, old age and abdominal pain is suggestive of mesenteric ischemia . The most common symptoms of mesenteric ischemia include excruciating abdominal pain, bloody diarrhea, and nausea/vomiting. Symptoms of chronic mesenteric ischemia caused by atherosclerosis include abdominal pain after eating and diarrhea, while that of acute mesenteric artery ischemia due to an embolus include diarrhea, sudden severe abdominal pain, and vomiting.
History
Patients suffering from mesenteric ischemia may have a positive history of:[1][2]
| Personal history | Medical history | Surgical history | Family history |
|---|---|---|---|
|
such as atrial fibrillation
|
|
Family history of |
Symptoms
The severity and rapidity of mesenteric vessels occlusion determine the symptoms of mesenteric ischemia. [3][4]
Systemic classification of acute and chronic mesenteric ischemia symptoms is as follows:
| Acute mesentric ischemia | Chronic mesenteric ischemia | |||
|---|---|---|---|---|
| General symptoms | Gastrointestinal symptoms | Life threatening symptoms | General symptoms | Gastrointestinal symptoms |
|
Arterial occlusion: 2-3 hours Venous occlusion: 5 hours to more than 30 days
Other associations:
|
Signs of shock: |
Other associations: | |
References
- ↑ Veenstra RP, ter Steege RW, Geelkerken RH, Huisman AB, Kolkman JJ (2012). "The cardiovascular risk profile of atherosclerotic gastrointestinal ischemia is different from other vascular beds". Am J Med. 125 (4): 394–8. doi:10.1016/j.amjmed.2011.09.013. PMID 22305578.
- ↑ Sreenarasimhaiah J (2005). "Chronic mesenteric ischemia". Best Pract Res Clin Gastroenterol. 19 (2): 283–95. doi:10.1016/j.bpg.2004.11.002. PMID 15833694.
- ↑ Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD (2004). "Acute mesenteric ischemia: a clinical review". Arch. Intern. Med. 164 (10): 1054–62. doi:10.1001/archinte.164.10.1054. PMID 15159262.
- ↑ Font VE, Hermann RE, Longworth DL (1989). "Chronic mesenteric venous thrombosis: difficult diagnosis and therapy". Cleveland Clinic journal of medicine. 56 (8): 823–8. PMID 2691119.