Mesenteric Ischemia
Mesenteric ischemia is poor circulation in the vessels supplying blood flow to your mesenteric organs: your stomach, liver, colon and intestine. With poor circulation, blockages can form and compromise the function of these organs.
Can be acute or chronic
Mesenteric ischemia can come on suddenly or build slowly and become an ongoing health issue. It is part of a systemic disease process known as peripheral vascular disease or peripheral artery disease (PAD).
Symptoms
Sudden, severe stomach pain
Acute mesenteric ischemia can cause sudden, severe stomach pain, sometimes with nausea or vomiting.
Severe stomach pain after eating
Chronic mesenteric ischemia often causes severe stomach pain 15–60 minutes after eating. The pain may last for as long as 2 hours and, unfortunately, tends to recur with every meal. You may also experience nausea, vomiting, diarrhea or flatulence.
Weight loss
Chronic mesenteric ischemia sometimes leads you to lose weight because, although you may feel hungry, you eat less or less frequently to avoid the pain.
Causes
Acute mesenteric ischemia is commonly caused by a blood clot, which travels to one of the mesenteric arteries and suddenly blocks blood flow. These clots often originate in the heart and are more common among patients with an irregular heartbeat or heart disease.
Chronic mesenteric ischemia is frequently due to atherosclerosis (hardening of the arteries), which slows the amount of blood flowing through the arteries. An artery becomes blocked by plaque, which is formed by fats and other materials circulating in your blood. As more plaque builds up along the blood vessel wall, the artery can narrow and stiffen. Eventually, enough plaque builds up to reduce blood flow or even completely block the arteries.
Diagnosis
See a vascular surgeon.
If you have the symptoms outlined above, see a vascular surgeon. You will be asked about your history of smoking, high blood pressure, diabetes and heart disease, and details about when and how often the symptoms occur and how long they last. The vascular surgeon will also perform a physical exam.
Tests may be recommended.
- A Doppler ultrasound, a CT angiogram (CTA), or an angiogram may be recommended.
- A computed tomography (CT) scan is the test of choice. A CTA creates detailed three-dimensional images from X-rays taken of cross-sections of your body.
- These images can identify problems with your arteries or with your abdominal organs.
- An angiogram (also called an arteriogram) is a more invasive test but may be preferred if a rapid diagnosis is very important. This test uses X-rays to view your blood vessels.
Treatment
The goal of treatment for mesenteric ischemia (both chronic and acute) is to re-open the artery to allow adequate blood flow to your intestine so it will work properly. This must be accomplished before permanent damage is done. The specifics of your condition will guide your vascular surgeon on whether to recommend treatment on an emergency or elective (scheduled procedure) basis.