Mesenteric artery ischemia Health Article

Definition

Mesenteric artery ischemia is a narrowing or blockage of one or more of the three mesenteric arteries, which are the major arteries supplying the small and large intestines.

Alternative Names

Mesenteric Vascular Disease

Causes, incidence, and risk factors

Narrowing of the arteries that supply blood to the intestine causes mesenteric ischemia. The arteries that supply blood to this area run directly from the aorta, the main artery from the heart.

Mesenteric artery ischemia is often seen in people with hardening of the arteries elsewhere in the body (for example, with coronary artery disease or peripheral vascular disease). The condition is more common in smokers and in patients with high cholesterol.

Mesenteric ischemia may also be caused by a blood clot (embolus) that moves through the blood and suddenly blocks one of the mesenteric arteries. The clots usually come from the heart or the aorta. These clots are more commonly seen in patients with abnormal heart rhythms (arrhythmias), such as atrial fibrillation.

Symptoms

Symptoms of long-term (chronic) mesenteric artery ischemia caused by atherosclerosis:

• Abdominal pain after eating
• Diarrhea

Symptoms of sudden (acute) mesenteric artery ischemia due to a traveling blood clot:

• Diarrhea
• Sudden severe abdominal pain
• Vomiting

Signs and tests

In acute mesenteric ischemia, blood tests may show a higher-than-normal white blood cell (WBC) count and changes in the blood-acid level.

A CT scan may show problems with the blood vessels and the intestine.

A mesenteric angiogram is a test that involves injecting a special dye into your bloodstream to highlight the arteries of an intestine. Then x-rays are taken of the area. This can show the location of the blockage in the artery.

Treatment

Acute mesenteric artery ischemia is an emergency. Surgery is performed to remove the clot. In some cases, the surgeon must also create a bypass around blockage.

Surgery for chronic mesenteric artery ischemia involves removing the blockage and reconnecting the arteries to the aorta. A bypass around the blockage is another procedure. It is usually done with a plastic tube graft.

An alternative to surgery is a stent. It may be inserted to enlarge the blockage of the mesenteric artery or deliver medicine directly to the affected area. This is a rather new technique and should only be done by experienced health care providers.