Acute mesenteric ischemia causes

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.

Causes

Occlusive Arterial Acute Mesenteric Ischemia (65-75%)

• Embolism (50%)
  • Atrial fibrillation
  • Heart failure
  • CAD
• Thrombus (15-25%)
  • Atherosclerosis
  • Infection
  • Trauma
• Strangulation

Occlusive Venous Acute Mesenteric Ischemia (5%)

• Inherited hypercoagulability
• Malignancy
• Pancreatitis

Non Occlusive Mesenteric Ischemia (20-30%)

• Aortic insufficiency
• Cocaine
• Drugs
  • Alpha agonists
  • Digitalis
  • Diuretics
• Sepsis