Mesenteric ischemia occurs when there is low blood flow to the intestines
or bowel caused by a blockage of the arteries that supply the small and
large intestine with blood flow.
There are three mesenteric arteries that supply blood flow from the heart
to the small and large intestines. Mesenteric artery stenosis (MAS) occurs
when there is a narrowing or blockage in one or more of these arteries.
It may also be caused by a blood clot that moves through the bloodstream,
blocking the mesenteric arteries, this is commonly found in individuals
who possess abnormal heart rhythms.
Mesenteric ischemia may occur in patients with:
- A long history of smoking
- Atrial fibrillation (a fast and irregular heart beat)
- Recent heart attack
Other risk factors include:
Signs of Mesenteric Artery Stenosis:
- High cholesterol
- Hypertension (high blood pressure)
- Lack of physical exercise
- Family history of vascular disease (in particular, peripheral vascular
disease or carotid artery disease)
Symptoms of chronic mesenteric artery stenosis (build up of plaque over
time that hardens the arteries include):
- Abdominal pain after eating
- Fear of eating
- Weight loss
Symptoms of sudden mesentery artery stenosis (due to a traveling blood clot):
- Sudden severe abdominal pain
- Lack of appetite
Diagnosis is usually based on a patient's history, symptoms, and physical
examination. Blood tests that may be helpful include white blood cell
( WBC) count and lactic acid levels.
Imaging tests that may show narrowing or blockage in the mesenteric arteries include:
- Duplex ultrasound
- CT Scan
- Mesenteric Angiogram
Chronic Mesenteric Ischemia:
Mesenteric angioplasty and stenting
- This involves opening the narrowed artery using a balloon and inserting
a stent (metal scaffolding) to keep it open. This is done through a small
groin puncture and usually involves overnight hospitalization.
Mesenteric artery bypass
- This involves a large open surgery using artificial bypass graft material
or your own vein to carry blood around the blocked areas in the arteries.
This may involve a hospital stay of several days.
Acute Mesenteric Ischemia:
This is a surgical emergency -- if not promptly treated, it may result
- Open surgery thrombectomy (removing the clot through an open operation)
Thrombolysis (performing an angiogram and using clot busting drugs to break
up the clot).
- This is seldom done in patients.
**There is no medical treatment, per se, for mesenteric ischemia. However,
tobacco cessation, healthy dietary habits, exercise, and drug therapy
(antiplatelet drugs such as aspirin and cholesterol lowering agents) can help to
slow the progression of disease and reduce the risk of recurrence.