Health

Is mesenteric venous occlusion as a cause of ischemic bowel disease?  Mesenteric venous occlusion is a rare cause of ischemic bowel disease, which requires an awareness of associated risk factors (often a hypercoagulable state) and a high index of suspicion for accurate diagnosis.  Patients with mesenteric venous occlusion generally present with severe midabdominal pain out of proportion …

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Pathophysiologic findings of nonocclusive mesenteric ischemia (NOMI)  NOMI occurs, as the name implies, without the presence of an embolus or thrombus. The risk of intestinal hypoperfusion can increase with shock, severe hypovolemia, decreased cardiac output, and during major thoracic or abdominal surgery as the mesenteric vasculature vasoconstricts. It can also be seen in patients taking …

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What is abdominal angina? What is its clinical significance?  Abdominal angina is an uncommon cause of intermittent abdominal pain. Patients with abdominal angina report severe cramping abdominal pain that begins 15 to 30 minutes after eating. This postprandial pain persists for 2 to 3 hours. Additional ingestion of food aggravates the patient’s pain, forcing the …

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Pathophysiologic findings of occlusive AMI  Intestinal ischemia results from tissue hypoxia, which can be secondary to a decrease in blood volume, red blood cell mass, flow rate, or oxygen content. As the radius of an artery decreases, the resistance to flow increases by a power of 4. Autoregulation results in vasodilation to maintain flow up …

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What clinical circumstances predispose to ischemic bowel disease? Arterial Occlusive Mesenteric Ischemia Embolus: cardiac arrhythmias, valvular heart disease, myocardial infarction, mural thrombus, atrial myxoma, angiography, trauma Thrombosis: atherosclerosis, hypercoagulable states (e.g., pregnancy, hyperhomocysteinemia, antiphospholipid syndrome, birth control pills, neoplasms, polycythemia vera, essential thrombocytosis, and paroxysmal nocturnal hemoglobinuria), vascular aneurysms or dissections, vasculitides Nonocclusive Mesenteric Ischemia Cardiac arrhythmias, …

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What are the different varieties of ischemic bowel disease?  Ischemic bowel disease can be sorted into various categories based on the vascular component affected (arterial or venous), the duration of reduction of blood flow through the vessel (acute or chronic), and the cause of the reduction in flow (occlusive or nonocclusive).  It can also be …

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An extensive collateral circulatory system exists between the systemic and splanchnic vascular networks The several systemic-splanchnic and intersplanchnic collateral channels that connect the three major mesenteric arteries and their branches become apparent in the event of occlusion of one of the major branches. Pancreaticoduodenal arcade provides collateral channels between the celiac axis and SMA (the superior …

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