Ischemic Intestinal Injury

General Principles

  • Acute mesenteric ischemia results from arterial (or rarely venous) compromise to the superior mesenteric circulation.
  • Emboli and thrombus formation are the most common causes of acute mesenteric ischemia, although nonocclusive mesenteric ischemia from vasoconstriction can also give rise to the disorder.
  • Ischemic colitis results from mucosal ischemia in the inferior mesenteric circulation during a low-flow state (hypotension, arrhythmias, sepsis, aortic vascular surgery), often in patients with atherosclerotic disease.1 Vasculitis, sickle cell disease, vasospasm, and marathon running can also predispose to ischemic colitis.
  • Chronic mesenteric ischemia is caused by atherosclerosis of all three major abdominal arteries leading to intermittent hypoperfusion.

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