Acute mesenteric ischemia causes: Difference between revisions

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==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>
==Causes==
==Causes==
===Occlusive Arterial Acute Mesenteric Ischemia (65-75%)===
===Occlusive Arterial Acute Mesenteric Ischemia (65-75%)===
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**[[Heart failure]]
**[[Heart failure]]
**[[CAD]]
**[[CAD]]
* [[Thrombosis]] (15-25%)
* [[Thrombus]] (15-25%)
** [[Atherosclerosis]]
** [[Atherosclerosis]]
** [[Infection]]
** [[Infection]]
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** [[Digitalis]]
** [[Digitalis]]
** [[Diuretics]]
** [[Diuretics]]
* [[Sepsis]] <ref>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>
* [[Sepsis]] <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>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 11:24, 12 December 2012

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

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.[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 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.