Mesenteric ischemia causes

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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

Narrowing of the arteries that supply blood to the intestine causes mesenteric ischemia. The arteries that supply blood to the intestines travel straight from the aorta. Mesenteric ischemia is often seen in people who have hardening of the arteries in other parts of the body (for example, those with coronary artery disease or peripheral vascular disease). The condition is more common in smokers and in patients with high blood pressure or blood cholesterol. Mesenteric ischemia can also be caused by an embolus that suddenly blocks one of the mesenteric arteries. The emboli usually come from the heart or aorta. These clots are more commonly seen in patients with arrhythmias, such as atrial fibrillation.

Causes

Mesenteric ischemia is classified into four categories. Each category has their own cause:[1][2][3][4][5][6][7][8][9][10][11][12][13]

Classification based on etiology
Etiology Cause Incidence Examples Mechanism
Occlusive causes Arterial embolism 50-70%
Arterial thrombosis 15-25%
Venous thrombosis 5% Mesenteric venous thrombosis:
Non-Occlusive causes Non-occlusive ischemia 20-30%
Rare causes

References

  1. Reinus JF, Brandt LJ, Boley SJ (1990). "Ischemic diseases of the bowel.". Gastroenterol Clin North Am. 19 (2): 319–43. PMID 2194948. 
  2. Di Fabio F, Obrand D, Satin R, Gordon PH (2009). "Intra-abdominal venous and arterial thromboembolism in inflammatory bowel disease.". Dis Colon Rectum. 52 (2): 336–42. PMID 19279432. doi:10.1007/DCR.0b013e31819a235d. 
  3. Ha C, Magowan S, Accortt NA, Chen J, Stone CD (2009). "Risk of arterial thrombotic events in inflammatory bowel disease.". Am J Gastroenterol. 104 (6): 1445–51. PMID 19491858. doi:10.1038/ajg.2009.81. 
  4. Stone JR, Wilkins LR (2015). "Acute mesenteric ischemia.". Tech Vasc Interv Radiol. 18 (1): 24–30. PMID 25814200. doi:10.1053/j.tvir.2014.12.004. 
  5. 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. PMID 16476108. doi:10.1111/j.1365-2796.2006.01613.x. 
  6. Acosta S, Ogren M, Sternby NH, Bergqvist D, Björck M (2005). "Clinical implications for the management of acute thromboembolic occlusion of the superior mesenteric artery: autopsy findings in 213 patients.". Ann Surg. 241 (3): 516–22. PMC 1356992Freely accessible. PMID 15729076. 
  7. Acosta S (2015). "Mesenteric ischemia.". Curr Opin Crit Care. 21 (2): 171–8. PMID 25689121. doi:10.1097/MCC.0000000000000189. 
  8. ter Steege RW, Sloterdijk HS, Geelkerken RH, Huisman AB, van der Palen J, Kolkman JJ (2012). "Splanchnic artery stenosis and abdominal complaints: clinical history is of limited value in detection of gastrointestinal ischemia.". World J Surg. 36 (4): 793–9. PMC 3299959Freely accessible. PMID 22354487. doi:10.1007/s00268-012-1485-4. 
  9. Otte JA, Huisman AB, Geelkerken RH, Kolkman JJ (2008). "Jejunal tonometry for the diagnosis of gastrointestinal ischemia. Feasibility, normal values and comparison of jejunal with gastric tonometry exercise testing.". Eur J Gastroenterol Hepatol. 20 (1): 62–7. PMID 18090993. doi:10.1097/MEG.0b013e3282ef633a. 
  10. Uemura S, Suzuki K, Katayama N, Imai H (2017). "Superior mesenteric artery syndrome leading to reversible mucosal gangrene.". Acute Med Surg. 4 (3): 375–376. PMC 5674473Freely accessible. PMID 29123896. doi:10.1002/ams2.283. 
  11. Moore HB, Moore EE, Lawson PJ, Gonzalez E, Fragoso M, Morton AP; et al. (2015). "Fibrinolysis shutdown phenotype masks changes in rodent coagulation in tissue injury versus hemorrhagic shock.". Surgery. 158 (2): 386–92. PMC 4492895Freely accessible. PMID 25979440. doi:10.1016/j.surg.2015.04.008. 
  12. Cohn DM, Roshani S, Middeldorp S (2007). "Thrombophilia and venous thromboembolism: implications for testing.". Semin Thromb Hemost. 33 (6): 573–81. PMID D 17768689 D . doi:10.1055/s-2007-985753. 
  13. Aschoff AJ, Stuber G, Becker BW, Hoffmann MH, Schmitz BL, Schelzig H; et al. (2009). "Evaluation of acute mesenteric ischemia: accuracy of biphasic mesenteric multi-detector CT angiography.". Abdom Imaging. 34 (3): 345–57. PMID 18425546. doi:10.1007/s00261-008-9392-8. 

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