SEARCH RESULTS FOR: Chronic-Mesenteric-Ischemia

Chronic Mesenteric Ischemia

Chronic Mesenteric Ischemia: Pathogenesis and clinical findings Age Diabetes Smoking Genetic & environmental factors (etiology largely unknown) HLA-B52 allele & other genetic factors Dyslipidemia (abnormal blood lipid levels) Various etiologies (trauma, coagulopathies, inflammatory bowel disease, paraneoplastic syndrome, surgery, portal hypertension, cardiac) High blood pressure Fibromuscular dysplasia (systemic vascular disease) Takayasu’s arteritis (systemic inflammatory artery disease) Median arcuate ligament syndrome Atherosclerosis (plaque deposition in the subendothelium; cause of 90% of chronic mesenteric ischemia cases) Arterial wall thickening Growth & hardening of arterial wall Compression of celiac trunk by the median arcuate ligament Thromboembolism (clot formation) Turbulent blood flow at the level of the lesion Mesenteric artery stenosis (narrowing) Abdominal bruit (audible whoosh due to artery narrowing) Mucosal and submucosal injury & inflammation Insufficient blood supply to the gastrointestinal tract to meet demand (i.e., “intestinal angina”) Diarrhea ± constipation Gut motility dysfunction Activation of the vomiting centre in the brain Chronic Mesenteric Ischemia Chronic hypoperfusion of the bowel due to (typically) multivessel mesenteric artery stenosis or occlusion for >3 months Aortic dissection (tear) Radiation exposure Vascular injury Exposure of subendothelium & disruption of blood flow Mesenteric artery occlusion (blockage) Compensation by the mesenteric vasculature through expansion of collateral circulation Majority of patients are asymptomatic Nausea & vomiting Detectable stenosis/occlusion of mesenteric arteries Intake of food increases metabolic demand of bowel beyond levels accommodated by strained blood supply Mesenteric artery stenosis/ occlusion with medical imaging (ie. CT Angiogram) Postprandial abdominal discomfort (typically epigastric pain ~30 minutes following a meal, lasting for 1-4 hours) Published May 19, 2025 on www.thecalgaryguide.com Author: Liam Fitzgerald Reviewers: Sophia Khan Shahab Marzoughi Sergio F. Sharif Sylvain P. Coderre* * MD at time of publication Tobacco use Buerger’s disease (inflammatory artery disease) Formation of focal inflammatory blood clots Weight loss (>20 lbs) Food aversion, smaller meals, avoidance of fatty foods (caloric restriction) Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications