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Acute intestinal
ischemia
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Normal |
Abnormal |
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- The superior mesenteric artery, a
large vessel that branches off the aorta, supplies the
intestine with blood. When a blood clot lodges in this
artery or its branches, it cuts off the blood supply to part
of the intestine. This is known as Intestinal Ischemia. When
this occurs, the intestine may infarct
(die).
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- Crampy or steady upper abdominal
pain
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- Embolic -- blood clots are thrown from the heart due to heart valve disease or atrial fibrillation
- Thrombosis --
blood clots form in the blood vessels
- Vascular insufficiency -- insufficient blood is being pumped to the arteries of the intestine. This can occur in patients with Congestive Heart Failure recently started on
Digoxin.
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- Minimal or no tenderness on abdominal exam
- Classically, pain is out of proportion to the exam
- Low Blood Pressure may be present
- Laboratory:
- Elevated white blood cell count
- Arterial Lactic acid level
may be elevated
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- Broad spectrum intravenous antibiotics to cover bowel flora, e.g., Ampicillin/Gentamicin/Flagyl
- Optimize blood pressure and blood oxygenation
- Surgical removal of necrotic (dead)
bowel
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- This is a life-threatening illness
and immediate emergency medical treatment is
needed.
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