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Mesenteric Infarction


Presentation

  • We present four cases of acute mesenteric infarction in patients with active ulcerative colitis: one presenting prior to the diagnosis of ulcerative colitis, two at the time of diagnosis, and one many years after the diagnosis had been made.[ncbi.nlm.nih.gov]
  • A realization that the presentation is often atypical should increase the likelihood of early recognition and lead to improved patient survival.[ncbi.nlm.nih.gov]
  • Of these 17, patients had presented at least one symptom of chronic intestinal ischemia before the fatal exacerbation.[ncbi.nlm.nih.gov]
  • We present a case of retrograde cerebral venous air emboli arising from the hepatic portal venous system, secondary to a mesenteric infarction. A 69-year-old man with a history of gastrointestinal amyloidosis presented with fever and lethargy.[ncbi.nlm.nih.gov]
  • A case of revascularization in mesenteric infarction by reimplantation of the superior mesenteric artery combined with intestinal resection is presented.[ncbi.nlm.nih.gov]
Fever
  • A 69-year-old man with a history of gastrointestinal amyloidosis presented with fever and lethargy.[ncbi.nlm.nih.gov]
  • Patients may present with 1 : sudden onset of abdominal pain right lower quadrant pain and tenderness absence of fever and gastrointestinal symptoms encountered in healthy patients, such as marathoners, because of low omental blood flow Primary omental[radiopaedia.org]
  • None of our patients had fever at the beginning, although in other series of patients the authors point out that fever is as frequent as abdominal pain. 10 Zeier et al. reported that, aside from abdominal pain, most of their patients presented hematochezia[revistanefrologia.com]
  • Clinical manifestations, such as fever, diarrhea and leukocytosis, are nonspecific, which makes early diagnosis of NOMI very difficult.[kjim.org]
  • Change in eating habits due to post-meal pain or fear of eating Flatulence Constipation Weight loss Abdominal swelling Nausea and vomiting Fever Diarrhea or constipation Rectal bleeding or bloody stools Rapid heartbeat Prevention of Mesenteric Ischemia[healthcommunities.com]
Severe Pain
  • Specialty Vascular surgery, gastroenterology Symptoms Acute : sudden severe pain[en.wikipedia.org]
  • The most important finding is moderate to severe pain that, upon examination, has no obvious cause. The pain is diffuse, nonlocalized, and constant. Acute Mesenteric Ischemia often presents with sudden and severe abdominal pain.[diagnose-me.com]
  • Her physical exam is normal, including vital signs, but she continues to complain of severe pain.[epmonthly.com]
Abdominal Pain
  • In particular they were more likely to have abdominal pain and distention and less likely to be confused.[ncbi.nlm.nih.gov]
  • Intestinal ischaemia is an important part of the differential diagnosis in patients with ulcerative colitis presenting with abdominal pain.[ncbi.nlm.nih.gov]
  • A 36-year-old woman with a history of left nephrectomy for renovascular hypertension secondary to arterial occlusive lesion of Takayasu's arteritis was re-admitted to our hospital with complaints of postprandial abdominal pain in the sixth post-operative[ncbi.nlm.nih.gov]
  • ., and Shih-Chieh Chang, M.D. 94 Citing Articles A 75-year-old woman with chronic atrial fibrillation presented to the hospital with a 2-day history of colicky abdominal pain.[nejm.org]
Vomiting
  • 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]
  • However, he developed acute small bowel obstruction as shown by increasing abdominal pain, left iliac fossa tenderness, abdominal distension, faeculent vomiting, obstructive bowel sounds, and dilated small bowel loops on abdominal radiography.[pmj.bmj.com]
  • The other 3 patients experienced shock and metabolic acidosis. white blood cell count over 10.5 – 98% lactic acid elevated – 91% nausea – 44% (other surveys have found nausea and vomiting in 75% of affected patients) vomiting – 35% diarrhea – 35% heart[diagnose-me.com]
  • […] of ruptured abdominal aortic aneurysm: (1) Abdominal pain, (2) Pulsatile abdominal mass, (3) Hypotension Classic triad for acute mesenteric ischemia: (1) Acute onset of abdominal pain which is classically out of proportion to the physical exam, (2) Vomiting[theweeklymnemonic.wordpress.com]
  • Critical Essential Core Tested Community Questions (2) (M2.GI.74) A 68-year-old male smoker with a history of peripheral vascular disease and a below the knee amputation, presents to the emergency room with excruciating abdominal pain and vomiting for[medbullets.com]
Overeating
  • Abstract Acute mesenteric infarction was diagnosed clinically or post mortem in 83 patients over a 10 years period in 4 surgical departments.[ncbi.nlm.nih.gov]
  • A retrospective review of 121 consecutive patients over a 6-year period was undertaken. Twenty-three patients died without operation, and mortality in the remaining 98 patients was 50 per cent.[ncbi.nlm.nih.gov]
  • Abstract The clinical features, the treatment given, the factors governing treatment selection, and the result of such treatment were analyzed in all patients aged 65 years and over in whom a tissue diagnosis of acute mesenteric infarction was made at[ncbi.nlm.nih.gov]
  • Patients with arterial mesenteric infarction or with NOMI are over three times more likely to die during the first hospital admission compared with those with venous mesenteric infarction.[ncbi.nlm.nih.gov]
Acute Abdomen
  • Although Takayasu's arteritis may present a wide variety of signs and symptoms depending on the vessel affected, it is rarely associated with acute abdomen requiring emergency laparotomy.[ncbi.nlm.nih.gov]
  • Mesenteric infarction should be suspected in all elderly cardiac patients with symptoms of acute abdomen. The value of an early diagnosis, fast resuscitation, and aggressive operative treatment cannot be overstated.[ncbi.nlm.nih.gov]
  • CONCLUSION: CT and angiography are highly sensitive, but CT can also be used to rule out other causes of acute abdomen.[ncbi.nlm.nih.gov]
  • CLINICAL AND SEROLOGIC MARKERS, WERE EXAMINED FOR STATISTICAL DIFFERENCE IN PATIENTS WITH ACUTE ABDOMEN FROM INTESTINAL ISCHAEMIA.[didaktorika.gr]
  • Abstract The paper presents a case of entero-mesenteric venous infarct, occurred in a man of 34 years, discovered intraoperator, when to intervene surgically in emergency surgery for acute abdomen of peritonitic type.[ncbi.nlm.nih.gov]
Severe Abdominal Pain
  • How Ohio State diagnoses mesenteric ischemia If you have sudden severe abdominal pain, you may have acute mesenteric ischemia or other abdominal problems, and should go to an emergency room immediately.[wexnermedical.osu.edu]
  • Snap Shot A 70-year-old male with atrial fibrillation presents to the emergency department with sudden onset of severe abdominal pain despite relatively benign findings on physical exam.[medbullets.com]
  • Ischemia in the small intestine interferes with digestion and can cause severe abdominal pain.[hopkinsmedicine.org]
  • Call your provider if you have: Changes in bowel habits Fever Nausea Severe abdominal pain Vomiting The following lifestyle changes can reduce your risk for narrowing of the arteries: Get regular exercise. Follow a healthy diet.[medlineplus.gov]
  • Acute Mesenteric Ischemia often presents with sudden and severe abdominal pain.[diagnose-me.com]

Treatment

  • Abstract The clinical features, the treatment given, the factors governing treatment selection, and the result of such treatment were analyzed in all patients aged 65 years and over in whom a tissue diagnosis of acute mesenteric infarction was made at[ncbi.nlm.nih.gov]
  • The value of an early diagnosis, fast resuscitation, and aggressive operative treatment cannot be overstated. Bowel resections yielded the best results in this series.[ncbi.nlm.nih.gov]
  • In view of the high recurrence rate in the early postoperative period, treatment must prevent the causes of persistent or recurrent ischaemia such as vasoconstriction and reperfusion tissue damage.[ncbi.nlm.nih.gov]
  • Although surgical resection of the necrotic bowel is the treatment of choice, the patient and her family opted for conservative treatment. The patient died 3 days later.[nejm.org]
  • An immediate surgical treatment with resection of the small bowel and right colon followed by a side-to-side primary anastomosis between the remaining jejunum and transverse colon were performed.[ncbi.nlm.nih.gov]

Prognosis

  • The clinical significance and prognosis in this setting requires further investigation.[ncbi.nlm.nih.gov]
  • Patients with primary venous mesenteric infarction showed a better survival rate (one death in eight patients) than patients with associated diseases such as liver cirrhosis, sepsis or previous operation who had a poor prognosis with a mortality comparable[ncbi.nlm.nih.gov]
  • The prognosis was significantly related to the patient's age and time lapse between clinical onset and operation.[link.springer.com]
  • Complications such as peritonitis and sepsis result in a poor prognosis.[amboss.com]
  • Prognosis In cases of mesenteric artery ischemia, prognosis is especially poor if the patient is not treated quickly. Even with treatment the risk of death is 30-90%, depending on the stage at which treatment is started.[diagnose-me.com]

Etiology

  • Abstract The most common etiologies of mesenteric infarction in fifty-one patients were arterial thrombosis (in 42 per cent), bowel infarction without major vessel occlusion (in 28 per cent), and arterial embolus (in 22 per cent), but the etiology also[ncbi.nlm.nih.gov]
  • Recent changes in the etiology of this disease have not been examined. A retrospective review of 121 consecutive patients over a 6-year period was undertaken.[ncbi.nlm.nih.gov]
  • Recommended operative procedures depend on the etiology of the infarction. Hyperalimentation may be of benefit early in the postoperative course to provide both nutrition and a chance for adaptation.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: A thrombotic tendency is the main etiological factor in most patients younger than 60 years. An anastomosis of the remaining jejunum to the colon can allow PN to be stopped.[ncbi.nlm.nih.gov]
  • Severe hemodynamic alterations either of cardiac origin or due to shock were important etiologic factors in cases of nonocclusive mesenteric infarction.[link.springer.com]

Epidemiology

  • 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]
  • […] 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]
  • The epidemiological analysis of the data from the Catalonian Register of Kidney Patients has reported a progressive increase in the mortality due to mesenteric ischemia; before the year 1991 it was 0.9% and between 1991-2002, it was 3%. 12 Besides, several[revistanefrologia.com]
  • Abstract Objective : To determine the incidence of rotavirus infection and some of its epidemiological criteria in Ramadi Maternity and children hospital.[iasj.net]
Sex distribution
Age distribution

Pathophysiology

  • In Gastrointestinal Diseases: Pathophysiology, Diagnosis, Management, Sleisenger, M.H., Fordtran, J.S., editors. Philadelphia-London-Toronto, W.B. Saunders Company, 1973, p. 1560 Google Scholar 17.[link.springer.com]
  • 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 bleeding[amboss.com]
  • This discussion will focus on the etiology, pathophysiology, diagnosis, and management of acute mesenteric ischemia. Table 86–1. Potential Causes of Acute Mesenteric Ischaemia[accessmedicine.mhmedical.com]
  • Mesenteric Ischemia Background Group of diseases caused by inadequate blood flow and tissue oxygenation to small bowel and mesentery Can be due to occlusive or non-occlusive obstructions Pathophysiology Mechanism Impairment of microcirculation occurs[fprmed.com]
  • Ischemic Colitis, as compared to Acute Mesenteric Ischemia of the Small Bowel Ischemic colitis usually involves non-occlusive pathophysiology and affects the watershed areas (splenic flexure and recto-sigmoid junction), and typically presents in older[errolozdalga.com]

Prevention

  • In view of the high recurrence rate in the early postoperative period, treatment must prevent the causes of persistent or recurrent ischaemia such as vasoconstriction and reperfusion tissue damage.[ncbi.nlm.nih.gov]
  • The benefit of preventive screening of other vital organs in highly atheromatous patients is discussed.[ncbi.nlm.nih.gov]
  • CHICAGO – Early recognition of mesenteric ischemia in young adults and children is essential to prevent bowel loss and other serious consequences associated with this rare condition, Dr. Michael Dalsing said at a vascular surgery symposium.[mdedge.com]
  • Your doctor may prescribe blood-thinning medications to prevent future blood clots. Angioplasty is another treatment option for narrowed arteries. A mesh tube called a stent is inserted into the narrowed artery to hold it open.[healthline.com]
  • Mesenteric Ischemia Prevention Know about some possible ways of preventing this condition: Smoking is a major risk factor of the condition. Hence, one should quit smoking to avoid this disorder.[primehealthchannel.com]

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