Mesenteric/small Bowl Ischemia

Etiology

  • Atherosclerosis, embolus, low flow (systemic hypo perfusion)

Risk Factors

  • Female > male
  • Smoking
  • Older age
  • Known atherosclerosis or RFs

Symptoms

  • Generalized abd/epigastric pain
  • Chronic ischemia causes progressive/persistent pain after meals→ angina of the gut→ food avoidance→ weight loss
  • W/acute mesenteric ischemia/infarct, pain is severe and patients severely ill
  • Venous mesenteric thrombosis causes acute sx, w/RFs related to hypercoaguable state

Physical Exam Findings

  • Sometimes abdominal bruits
  • Abdominal exam often unremarkable
  • Sometimes guaiac +, rarely gross blood
  • May have other manifestations of vascular disease (e.g. diminished extremity pulses)