Also Known As
Intestinal ischemia
Description
* The superior mesenteric artery, a large vessel that branches off the aorta, supplies part of the intestine with blood. When a blood clot lodges in this artery or its branches, it cuts of the blood supply to part of the intestine. This is known as intestinal ischemia. When this occurs, the intestine may infarct (die).
Symptoms
* Crampy or steady upper abdominal pain
Cause
* Embolic -- blood clots are thrown from the heart due to heart valve disease or atrial fibrillation
* Thrombosis -- blood clots form in the blood vessels
* Vascular insufficiency -- insufficient blood is being pumped to the arteries of the intestine. This can occur in patients with Congestive Heart Failure recently started on Digoxin.
How The Diagnosis Is Made
* Classically, pain is out of proportion to the exam
* Low Blood Pressure may be present
* Laboratory:
1. Elevated white blood cell count
2. Arterial Lactic acid level may be elevated
3. Angiography -- dye injected and X-Rays taken to determine area of embolism
Treatment
* Broad spectrum intravenous antibiotics to cover bowel flora, e.g., Ampicilin/Gentamicin/Flagyl
* Optimize blood pressure and blood oxygenation
* Surgical removal of necrotic (dead) bowel
If You Suspect This Condition
* This is a life-threatening illness and immediate emergency medical treatment is needed.
Similiar Conditions
* Acute mesenteric Occlusion
* Ulcer Disease
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