Presentation
Patients presenting with acute mesenteric ischaemia alone face a high mortality rate as high as 60% whereas those presenting with peptic ulcer perforation the mortality rates range from 6-14%. [ncbi.nlm.nih.gov]
ADVERTISEMENT Click image to enlarge Clinical Presentation As shown in Table 1, symptoms and presentations are nonspecific, which can provide a false sense of security. [epmonthly.com]
Entire Body System
- Weight Loss
These blood clots in the small intestine and bowels can lead to: Weight loss Pain with eating Fear of food Left untreated over time, blockages can decrease blood flow so much that the tissues in your intestines die. [upmc.com]
A second patient with Takayasu’s presented with a 4-month history of abdominal pain, a 50-pound weight loss, stenosis of all major mesenteric arteries, and bowel pneumatosis. [mdedge.com]
loss and malabsorption Bloating, nausea, occasional diarrhea Abdominal bruit caused by stenosis of mesenteric vessels A patient typically presents with postprandial abdominal pain ( abdominal angina ), food aversion, and weight loss! [amboss.com]
loss AND YOU may hear the story of FOOD FEAR ( Pat comes with chronic abdominal pain right after meal/ u recall angina pain that like pain with exertion) Dx; CBC/leukocytosis, Lactic/or metabolic ACIDOSIS, Amylase UP. [usmleforum.com]
Gastrointestinal
- Abdominal Pain
A 79-yr-old man with previously documented atherosclerotic vascular disease presented with acute abdominal pain, signs of peritoneal irritation, and guaiac-positive stool. [ncbi.nlm.nih.gov]
- Vomiting
We present the case of an 84-year-old woman who presented to our emergency department complaining of an acute worsening of pre-existing abdominal periumbilical pain, nausea, vomiting, and diarrhea. [ncbi.nlm.nih.gov]
Arterial emboli typically originate from a cardiac source. 1,2 Case Report A male in his fifth decade presented with acute abdominal pain, vomiting, and diarrhea. [acgcasereports.gi.org]
Pancreatitis Portal hypertension/cirrhosis Medications Vasopressor medications Beta-blockers Digoxin Diuretics Clinical signs and symptoms Severe abdominal pain out of proportion to physical exam Pain initially of a visceral nature and poorly localized Nausea Vomiting [learningradiology.com]
You may also experience nausea, vomiting, diarrhea or flatulence. WEIGHT LOSS CHRONIC mesenteric ischemia sometimes leads you to lose weight because, although you may feel hungry, you eat less or less frequently to avoid the pain. [vascular.org]
Therefore, decreased blood supply to these organs cause symptoms related to eating or after-meal digestion, including: Abdominal pain after meals Weight loss Fear of eating or change in eating habits due to post-meal pain Nausea and/or vomiting Constipation [my.clevelandclinic.org]
- Diarrhea
We present the case of an 84-year-old woman who presented to our emergency department complaining of an acute worsening of pre-existing abdominal periumbilical pain, nausea, vomiting, and diarrhea. [ncbi.nlm.nih.gov]
ISCHEMIC COLITIS You see pat L side abdominal pain with BLOODY DIARRHEA/[Note: in mild cases pat usually have blooding diarrhea but no abdominal pain] (due to mucosal or mural infarction) as u know MC site splenic flexure and rectum most commonly spared [usmleforum.com]
[…] with acute arterial embolism typically presents with severe abdominal pain, fever, bloody diarrhea, leukocytosis and atrial fibrillation ! [amboss.com]
Arterial emboli typically originate from a cardiac source. 1,2 Case Report A male in his fifth decade presented with acute abdominal pain, vomiting, and diarrhea. [acgcasereports.gi.org]
[…] hypertension/cirrhosis Medications Vasopressor medications Beta-blockers Digoxin Diuretics Clinical signs and symptoms Severe abdominal pain out of proportion to physical exam Pain initially of a visceral nature and poorly localized Nausea Vomiting Diarrhea [learningradiology.com]
- Nausea
We present the case of an 84-year-old woman who presented to our emergency department complaining of an acute worsening of pre-existing abdominal periumbilical pain, nausea, vomiting, and diarrhea. [ncbi.nlm.nih.gov]
Pancreatitis Portal hypertension/cirrhosis Medications Vasopressor medications Beta-blockers Digoxin Diuretics Clinical signs and symptoms Severe abdominal pain out of proportion to physical exam Pain initially of a visceral nature and poorly localized Nausea [learningradiology.com]
You may also experience nausea, vomiting, diarrhea or flatulence. WEIGHT LOSS CHRONIC mesenteric ischemia sometimes leads you to lose weight because, although you may feel hungry, you eat less or less frequently to avoid the pain. [vascular.org]
Therefore, decreased blood supply to these organs cause symptoms related to eating or after-meal digestion, including: Abdominal pain after meals Weight loss Fear of eating or change in eating habits due to post-meal pain Nausea and/or vomiting Constipation [my.clevelandclinic.org]
- Severe Abdominal Pain
The diagnosis of mesenteric ischemia should be considered in patients of any age presenting with recurrent or severe abdominal pain, particularly when no alternative cause is apparent. [ncbi.nlm.nih.gov]
Severe abdominal pain develops suddenly. Angiography may be performed. Immediate treatment is needed using angiography or surgery. Acute mesenteric ischemia has multiple causes. [merckmanuals.com]
abdominal pain out of proportion to physical exam Pain initially of a visceral nature and poorly localized Nausea Vomiting Diarrhea GI bleeding may be present Imaging Plain abdominal radiographs (abnormal in 20-60% of cases) Thumbprinting Non-specific [learningradiology.com]
Cardiovascular
- Mitral Valve Prolapse
Echocardiography showed enlargement of the aortic root and mitral valve prolapse. Abdominal computed tomography scan revealed acute mesenteric ischemia due to abdominal aortic dissection. [ncbi.nlm.nih.gov]
- Diastolic Murmur
Cardiovascular examination revealed a grade 3 mid-diastolic murmur at left second intercostal space radiating to the axilla. Respiratory and abdominal examinations were unremarkable. [ijcasereportsandimages.com]
- Mid-Diastolic Murmur
Cardiovascular examination revealed a grade 3 mid-diastolic murmur at left second intercostal space radiating to the axilla. Respiratory and abdominal examinations were unremarkable. [ijcasereportsandimages.com]
Workup
On further workup, our patient was diagnosed with isolated protein S deficiency. We started lifelong thromboprophylaxis with warfarin to prevent recurrence and our patient was asymptomatic on the latest follow-up 5 months after discharge. [ncbi.nlm.nih.gov]
Although we pointed out the limitations of CT-scan, we keep thinking that it should remain the cornerstone of the diagnostic workup of AMI in the ICU. [annalsofintensivecare.springeropen.com]
Treatment
The treatment strategy is straightforward aiming at rapid restoration of blood flow to the intestine. Bowel resection is performed on demand. [ncbi.nlm.nih.gov]
In this group “technical success” is defined as meaning that treatment with VIR is sufficient (no rescue surgical treatment is needed); “therapeutic success” means that treatment using VIR is not sufficient and rescue surgery is necessary (intestinal [elsevier.es]
Prognosis
The prognosis of AMI is extremely poor. The main mechanism of AMI is NOMI, occurring in approximately 80% of patients. Further progress should be performed on prevention and earlier diagnosis. [ncbi.nlm.nih.gov]
Etiology
Acuity of presentation, presence of bowel infarction, etiology of the ischemia, and risk factors may influence a planned treatment approach. [ncbi.nlm.nih.gov]
Risk factors for AMI vary depending on the underlying etiology. [radiologykey.com]
Epidemiology
Epidemiological data, CT findings, and the primary end point defined as the composite of intestinal ischemia or necrosis based on surgical finding and in-hospital mortality were investigated. [ncbi.nlm.nih.gov]
Epidemiology The incidence of ischaemic colitis has risen from 6.1 cases/100 000 person-years in 1976-80 to 22.9/100 000 in 2005-09 [ 5 ]. Many mild cases may go unreported. [patient.info]
Biochemistry (187) Genetics (137) Infectology (107) Nephrology (97) Microbiology (89) Surgery, Traumatology and Orthopaedics (82) Gastroenterology and Hepatology (70) Neurology (70) Cardiology, Angiology (66) Pharmacology (63) Endocrinology, Metabolism (55) Epidemiology [portal.mefanet.cz]
[…] flow to the small intestine (arterial or venous) that can result in bowel infarction Chronic mesenteric ischemia : constant or episodic hypoperfusion of the small intestine, usually due to atherosclerosis References: [1] [2] [3] [4] Ischemic colitis Epidemiology [amboss.com]
Risk Factors & Epidemiology ▪ Atherosclerosis. ▪ Arrhythmias. ▪ Hypovolemia. ▪ CHF. ▪ recent MI. ▪ valvular disease. ▪ advanced age. ▪ intra-abdominal malignancy. ▪ IBD. ▪ AMI is commonly considered a disease of the older population(>60), but may affect [slideshare.net]
Pathophysiology
This is the first report of massive bowel ischaemia and duodenal perforation with no apparent underlying common pathophysiology leading to this presentation. [ncbi.nlm.nih.gov]
Pathophysiology The main mechanism underlying mesenteric ischemia is decreased blood flow to the small intestine. [wikidoc.org]
Pathophysiology Intestinal blood flow of the superior mesenteric artery ( SMA ) and/or inferior mesenteric artery ( IMA ) is suddenly compromised (see “Etiology” for causes) → intestinal hypoxia → intestinal wall damage → mucosal inflammation + possibly [amboss.com]
I just read that wikipedia page... please refer on that same page to "non-occlusive ischemia" and "pathophysiology". [forums.studentdoctor.net]
This review article explains the pathophysiology, diagnosis, and treatment of intestinal ischemic syndromes. Funding and Disclosures Disclosure forms provided by the authors are available with the full text of this article at NEJM.org. Dr. [nejm.org]
Prevention
We suggest that endovascular treatment is a feasible option in patients with AMI and can prevent intestinal infarction. [ncbi.nlm.nih.gov]
After recovery, many people need to take a drug to help prevent blood clotting. [merckmanuals.com]