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IR Playbook pp 271-284 | Cite as

Mesenteric Ischemia

  • Andrew Chi
  • James R. Stone
Chapter

Abstract

Mesenteric ischemia occurs when the arterial blood supply fails to meet the functional demands of the intestine. This may cause abdominal pain, malnutrition, and/or bowel infarction, depending on the severity of mismatch between blood supply and functional demand. It is most commonly seen in the elderly and may be categorized as acute or chronic mesenteric ischemia. Common etiologies of acute mesenteric ischemia (AMI) include arterial embolus, mesenteric arterial thrombosis, aortic dissection, superior mesenteric and/or portal venous thrombosis, and nonocclusive mesenteric ischemia. Mesenteric ischemia is most commonly caused by atherosclerosis; it is relatively uncommon due to the rich collateral circulation of the gastrointestinal tract.

Bowel infarction in the setting of mesenteric ischemia is associated with mortality rates that have approached 90% in some studies. Thus, it is important to establish an early diagnosis and implement prompt treatment prior to the onset of bowel infarction. Acuity of presentation, presence of bowel infarction, etiology of ischemia, and risk factors may influence a planned treatment approach. While traditional therapy for mesenteric ischemia involved surgical management, successful endovascular approaches have been increasingly reported in multiple case series.

Keywords

Mesenteric ischemia Acute mesenteric ischemia Chronic mesenteric ischemia Papaverine Bowel Infarction Atherosclerosis Thrombosis Celiac artery Superior mesenteric artery Inferior mesenteric artery Superior mesenteric vein Portal vein Abdominal pain Endovascular PTA Stent 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Colorado, Department of RadiologyDenverUSA
  2. 2.University of Virginia Health System, Department of Radiology and Medical ImagingCharlottesvilleUSA

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