What clinical circumstances predispose to ischemic bowel disease

What clinical circumstances predispose to ischemic bowel disease?


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, hypoperfusion (cardiogenic shock, hypovolemia, sepsis), and vasoconstricting drugs (digoxin, cocaine)


• Hypercoagulable states (arterial causes, plus deficiencies of factor V Leiden, protein C and S, or antithrombin III), congestive heart failure, shock, portal hypertension, hepatic vein thrombosis (Budd-Chiari syndrome), malignancy, trauma, sclerotherapy, peritonitis, diverticulitis, pancreatitis, inflammatory bowel disease, intestinal obstruction, postoperative states, trauma


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