Mesenteric Ischemia

Definition

The mesenteric arteries supply blood to your small and large intestines. Ischemia usually occurs when one or more of your mesenteric arteries narrows or becomes blocked. When this happens, intestines are deprived of the oxygen needed to function, resulting in severe abdominal pain. Untreated, the blockage can quickly worsen over time and cause tissues in the intestine to die. Mesenteric ischemia can also impact intra-abdominal organs such as the colon, liver, and stomach.

Mesenteric Ischemia typically affects people over the age of 60. You may also be more likely to experience mesenteric ischemia if you are a smoker or have a high cholesterol level.

Chronic Mesenteric Ischemia –Typically, severe pain is experienced in the middle or upper part of the abdomen 15 to 60 minutes after eating. The pain can last as up 60 to 90 minutes and then disappear, returning the next time you eat. Due to this pain can lead to rapid weight loss. 

Other symptoms of mesenteric ischemia may present like other conditions, such as constipation, diarrhea, flatulence, nausea, and vomiting.

Acute Mesenteric Ischemia – Acute symptoms of severe stomach pain start suddenly and become very serious in a short period of time.  Acute mesenteric ischemia may also be accompanied by nausea or vomiting. Emergency care is required.

A frequent cause of chronic mesenteric ischemia is atherosclerosis (narrowing/hardening of veins), that reduces the flow of blood through the mesenteric veins. In acute mesenteric ischemia, a blood clot originating in the heart can travel to the mesenteric arteries and suddenly block blood flow.

Other conditions that may lead to mesenteric ischemia include:

  • Aortic dissection – A tear in the aorta’s inner layer

  • Coagulation disorders

  • Congestive heart failure

  • Low blood pressure

  • Occlusion or blockage of the veins in the bowel

  • Unusual disorders of the blood vessels (fibromuscular dysplasia and arteritis)

The treatment goal for both acute and chronic conditions is to re-open the artery to allow adequate blood flow and oxygen to reach the intestine. 

  • Trans-aortic Endarterectomy – This operation for chronic mesenteric ischemia removes the plaque blocking the inner lining of the artery with an incision in the abdomen or side. 

  • Bypass surgery – A detour around a narrowed or blocked bypass is made. The bypass goes above and below the blocked area, producing a new path for blood to flow.

  • Angioplasty and stenting – This minimally invasive method is used to open and brace a mesenteric artery for better blood flow. It has a shorter recovery period and can usually be performed at the time as an angiogram.

  • Thrombolytic agent – A medication that is injected into a blood vessel to dissolve a clot for acute mesenteric ischemia. If time does not allow injection of the medication, the clot may need to be removed surgically.  

  • Surgery – With acute mesenteric ischemia, in addition to restoring blood flow to intestinal arteries, surgery may be required to remove damaged portions of the intestine.

You can depend on the expert team of medical professionals at Vascular Tyler to help you determine your best treatment options, based on your test results.

For questions or to schedule an appointment, contact us at 903.533.8702.

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