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.[1]
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-
| ||
| Acquired thrombophilia- malignancy, oral contraceptives intake. | ||
| Non-occlusive | Heart failure | |
| Aortic insufficiency | ||
| Septic shock | ||
| Vasoconstrictive drugs: | ||
| 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:[2]
- Atrial fibrillation
- Cardiac arrhythmias
- Valvular heart diseases
- Infective endocarditis
- Recent myocardial infarction
- Ventricular aneurysm
- Aortic atherosclerosis
- Aortic aneurysm
- Thrombotic causes:[3]
- Advanced age
- Low cardiac output states
- Traumatic injury
- Peripheral artery disease
- Non-modifiable causes**
- Non-occlusive causes:[4]
- 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]
References
- ↑ Corcos O, Nuzzo A (2013). "Gastro-intestinal vascular emergencies". Best Pract Res Clin Gastroenterol. 27 (5): 709–25. doi:10.1016/j.bpg.2013.08.006. PMID 24160929.
- ↑ Fitzgerald T, Kim D, Karakozis S, Alam H, Provido H, Kirkpatrick J (2000). "Visceral ischemia after cardiopulmonary bypass". Am Surg. 66 (7): 623–6. PMID 10917470.
- ↑ Martinelli I, Mannucci PM, De Stefano V, Taioli E, Rossi V, Crosti F; et al. (1998). "Different risks of thrombosis in four coagulation defects associated with inherited thrombophilia: a study of 150 families". Blood. 92 (7): 2353–8. PMID 9746774.
- ↑ 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.