Mesenteric ischemia history and symptoms

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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, unless proven otherwise. 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 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

Acute mesenteric ischemia Chronic mesenteric ischemia
General symptoms Gastrointestinal symptoms Life threatening symptoms General symptoms Gastrointestinal symptoms
  • Site: Periumbilical. Focal pain in case of bowel necrosis.
  • Onset: Sudden
  • Character: Sharp or colicky
  • Severity: Moderate to severe
  • Timing, duration and frequency:
    • Arterial occlusion: 2-3 hours
    • Venous occlusion: 5 hours to more than 30 days
  • Aggravating and relieving factors: No association with meals

Other associations:

Signs of shock:
  • Site: Poorly localised
  • Onset: Insidious
  • Character: Transient episodes of pain.
  • Severity: Mild
  • Timing, duration and frequency: Months
  • Aggravating and relieving factors: Worse after meals.

Other associations:

References

  1. 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. PMID 22305578. doi:10.1016/j.amjmed.2011.09.013. 
  2. Sreenarasimhaiah J (2005). "Chronic mesenteric ischemia.". Best Pract Res Clin Gastroenterol. 19 (2): 283–95. PMID 15833694. doi:10.1016/j.bpg.2004.11.002. 
  3. Oldenburg WA, Lau LL, Rodenberg TJ, Edmonds HJ, Burger CD (2004). "Acute mesenteric ischemia: a clinical review". Arch. Intern. Med. 164 (10): 1054–62. PMID 15159262. doi:10.1001/archinte.164.10.1054. 
  4. 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. 
  5. Bobadilla, Joseph L. (2013). "Mesenteric Ischemia". Surgical Clinics of North America. 93 (4): 925–940. ISSN 0039-6109. doi:10.1016/j.suc.2013.04.002. 

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