Mesenteric artery ischemia
Overview
Mesenteric artery ischemia is a narrowing or blockage of one or more of the three mesenteric arteries, which are the major arteries supplying the small and large intestines.
Symptoms
Symptoms of long-term (chronic) mesenteric artery ischemia caused by atherosclerosis: Abdominal pain after eating Diarrhea Symptoms of sudden (acute) mesenteric artery ischemia due to a traveling blood clot: Diarrhea Sudden severe abdominal pain Vomiting
Causes
Narrowing of the arteries that supply blood to the intestine causes mesenteric ischemia. The arteries that supply blood to this area run directly from the aorta, the main artery from the heart. Mesenteric artery ischemia is often seen in people with hardening of the arteries elsewhere in the body (for example, with coronary artery disease or peripheral vascular disease). The condition is more common in smokers and in patients with high cholesterol. Mesenteric ischemia may also be caused by a blood clot (embolus) that moves through the blood and suddenly blocks one of the mesenteric arteries. The clots usually come from the heart or the aorta. These clots are more commonly seen in patients with abnormal heart rhythms (arrhythmias), such as atrial fibrillation.
Prognosis
In the case of chronic mesenteric ischemia, the outlook after a successful surgery is good. However, if appropriate lifestyle changes (such as a healthy diet and exercise) are not made, any problems with hardening of the arteries will generally get worse over time. Persons with acute mesenteric ischemia usually do poorly, since death of the intestine often occurs before surgery is done. However, when diagnosed and treated right away, patients with acute mesenteric ischemia can be treated successfully.
Treatment
Acute mesenteric artery ischemia is an emergency. Surgery is performed to remove the clot. In some cases, the surgeon must also create a bypass around blockage. Surgery for chronic mesenteric artery ischemia involves removing the blockage and reconnecting the arteries to the aorta. A bypass around the blockage is another procedure. It is usually done with a plastic tube graft. An alternative to surgery is a stent. It may be inserted to enlarge the blockage of the mesenteric artery or deliver medicine directly to the affected area. This is a rather new technique and should only be done by experienced health care providers