Acute Mesenteric Ischaemia

Blood Supply

  • Foregut
    • Stomach and part of duodenum, biliary system, liver, pancreas
    • Celiac artery
  • Midgut
    • Duodenum to 1st¬†half of transverse colon
    • Superior mesenteric artery
  • Hindgut
    • 2nd¬†half of transverse colon to rectum
    • Interior mesenteric

 

Acute Mesenteric Ischaemia

  • Caused by bloods clots blocking blood supply in mesenteric vessels (embolus or thrombus)
  • Presents as non-specific abdominal pain (disproportionate to exam findings)
  • Later can develop shock, peritonitis and systemic inflammatory response
  • Do blood lactate which may be raised
  • Diagnose with CT angiogram
  • Ultimately results in gangrene /- perforation

 

Risk Factors

  • Older age
  • Atrial fibrillation
  • Atherosclerosis
  • Coagulation disorders

 

Management

  • Fluid resuscitation
  • Thrombolysis
  • Surgical intervention
  • Very poor prognosis
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