Mesenteric Arterial Occlusive Disease
What is Mesenteric Arterial Occlusive Disease?
Mesenteric ischemia is poor circulation in the vessels supplying blood flow to the mesenteric organs: stomach, liver, colon, and intestine.
Three major vessels serve the abdominal contents:
- Celiac trunk: Supplies the esophagus, stomach, proximal duodenum, liver, gallbladder, pancreas, and spleen
- Superior mesenteric artery (SMA): Supplies the distal duodenum, jejunum, ileum, and colon to the splenic flexure
- Inferior mesenteric artery (IMA): Supplies the descending colon, sigmoid colon, and rectum
ACUTE Mesenteric Ischemia
This 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
This is frequently due to atherosclerosis (hardening of the arteries), which slows the amount of blood flowing through the arteries. The plaque can cause the artery to narrow and stiffen which can reduce the blood flow or completely block the arteries.
- If the symptoms are related to a blood clot blocking the artery thrombolysis is usually done. Thrombolysis involves injecting clot-dissolving medication into a blood vessel and is often given at the same time as a diagnostic angiogram.
- Sometimes surgery may be required to remove the clot and restore blood flow to your intestinal arteries (Embolectomy, revascularization, with or without bowel resection).
- Treatment is usually an emergency as it can cause rapid severe intestinal damage.
- Angiogram with balloon angioplasty and stenting.
- Bypass surgery if angioplasty is not an option or if it was unsuccessful.