Acute/Chronic Mesenteric Ischaemia

Causes

Acute mesenteric ischemia is most commonly caused by a blood clot that blocks one of the mesenteric arteries. This can happen if a blood clot travels from another part of the body (embolism) or if a clot forms in one of the mesenteric arteries themselves (thrombosis).

Chronic mesenteric ischemia is most commonly caused by atherosclerosis, a condition that causes fatty deposits to build up on the walls of the arteries. This narrowing of the arteries reduces the flow of blood to the intestines.

Risk Factors

Several factors can increase your risk of developing mesenteric ischemia, including:

• Age (60 or older)
• Atherosclerosis
• Smoking
• High blood pressure
• High cholesterol
• Diabetes
• A history of blood clots

Symptoms

The symptoms of mesenteric ischemia can vary depending on the severity of the condition.

• Acute mesenteric ischemia often causes severe abdominal pain that is out of proportion to the physical examination findings. The pain may be constant or cramping, and it may worsen after eating. Other symptoms of acute mesenteric ischemia may include:
  • Nausea and vomiting
  • Diarrhea
  • Bloody stools
  • Abdominal distention
  • Fever
  • Weakness
• Chronic mesenteric ischemia often causes vague abdominal pain that comes and goes, especially after eating. The pain may improve with rest and fasting. Other symptoms of chronic mesenteric ischemia may include:
  • Weight loss
  • Nausea and vomiting
  • Diarrhea
  • Feeling bloated after eating

Diagnosis

Mesenteric ischemia can be difficult to diagnose because the symptoms can be similar to other conditions. Doctors will use a variety of tests to diagnose mesenteric ischemia, including:

• Physical examination
• Blood tests
• Abdominal X-ray
• CT scan
• Angiography

Treatment

The treatment for mesenteric ischemia depends on the severity of the condition.

• Acute mesenteric ischemia is a surgical emergency. Surgery is needed to remove the blood clot and restore blood flow to the intestines. In some cases, the damaged portion of the intestine may need to be removed.
• Chronic mesenteric ischemia can be treated with medications, lifestyle changes, or surgery. Medications can help to lower blood pressure, cholesterol, and improve blood flow. Lifestyle changes, such as quitting smoking and eating a healthy diet, can also help to improve blood flow. Surgery may be needed to bypass the narrowed arteries or to remove a section of the intestine.

Angioplasty and stenting can be performed to reopen the mesenteric blood vessels that have been gradually narrowed over time due to plaque buildup (Click here to read more on Angioplasty/ stenting). Thrombolysis and thrombectomy can be performed to reopen the mesenteric blood vessels that have been suddenly blocked by a blood clot (Click here to read more on Thrombolysis / mechanical thrombectomy for acute arterial thrombosis).

Prevention

The best way to prevent mesenteric ischemia is to maintain a healthy lifestyle. This includes:

• Eating a healthy diet
• Exercising regularly
• Maintaining a healthy weight
• Quitting smoking
• Controlling blood pressure
• Controlling cholesterol