Acute Mesenteric Ischemia

Mesentery refers to the tissues that connect the blood vessels to the intestines. Ischemia refers to a restriction in blood supply. Mesenteric ischemia happens when an artery or vein that supports the intestine becomes blocked or narrow. Acute mesenteric ischemia (AMI) happens suddenly and can be life-threatening.

CAUSES

When blood supply to the intestine is severely restricted, needed oxygen cannot reach the intestines for proper function. Causes of AMI include:

  • A blood clot. This may develop due to heart attack, heart failure, or an irregular heartbeat (arrhythmia).

  • Low blood pressure. This may be due to shock, heart failure, certain medicines, dialysis, or kidney failure.

People at the greatest risk for mesenteric ischemia are those over the age of 50 with a history of coronary or vascular disease and people who smoke.

SYMPTOMS

  • Sudden, severe abdominal pain or bloating.

  • Blood in the stool.

  • Nausea.

  • Diarrhea, which is often bloody.

  • Vomiting.

  • Fever.

DIAGNOSIS

AMI is a medical emergency. Immediate evaluation and treatment is necessary. To confirm a diagnosis of AMI, your caregiver may perform:

  • A history and physical exam.

  • X-rays or CT scans.

  • Blood tests.

  • Angiography. This imaging test uses a dye to obtain a picture of blood flow to the intestine.

  • Exploratory laparotomy. This is surgery that opens the abdomen and examines the intestines for signs of tissue death. Dead intestines will need to be removed.

TREATMENT

Treatment of AMI almost always means emergency surgery. Patients who need this treatment are very sick and will need to be in the intensive care unit (ICU) after surgery. This is a life-threatening condition.