Atherosclerosis, embolus (a fib, ventricular thrombus), low flow (systemic hypo-perfusion)
Venous thrombosis, with RFs below
SMA Syndrome - very rare condition where SMA compressed by duodenum - associated w/rapid weight loss, scoliosis surgery--> change in anatomic relationships
Risk Factors
Female > male
Smoking
Older age
Known atherosclerosis or RFs (DM, HTN, hyperlipidemia)
Venous mesenteric thrombosis: hypercoaguable state→ factor 5 leiden defic, protein S/C/AT 3 defic, prothombin mutation, antiphoslipid antibody synd, parox noct hemoglobinuria; history of idiopathic dvt/pe, malignancy, other inflam process
Symptoms
Generalized abd/epigastric pain
Chronic ischemia causes progressive/persistent pain after meals→ angina of the gut→ food avoidance→ weight loss
With acute mesenteric ischemia/infarct, pain is severe and patients severely ill
Physical Exam Findings
Sometimes abdominal bruits
Abdominal exam often unremarkable (i.e. pain out of proportion to findings)
Sometimes guaiac +, rarely gross blood
May have other manifestations of vascular disease (e.g. diminished extremity pulses)