Recent Modalities In Management Of Mesenteric Vascular Occlusion

Abstract

Mesenteric ischemia accounts for approximately 1% of acute abdomen hospitalizations. Classically, classified into acute and chronic mesenteric ischemia . (Coco and Leanza, 2018). Acute mesenteric ischemia (AMI) is associated with a dramatic onset of severe cramp-like abdominal pain disproportionate to physical exam findings, followed after approximately 3 to 6 hours by a deceptive pain-free interval . Development of symptoms within minutes (in embolism) to hours (in athero-thrombosis). (Ierardi et al., 2017) In patients with chronic mesenteric ischemia, the association of pain and nausea with meals leads to fear of eating and subsequent weight loss. The evolution of symptoms is typically gradual (over months) and progressive. (Guo et al., 2017) Most of cases with intestinal ischemia is caused by an arterial embolus or thrombosis within the superior mesenteric artery. In cases of embolic occlusion, the absence of a well-developed collateral circulation causes earlier ischemia and transmural necrosis compared to other causes of mesenteric ischemia. Other causes are venous thrombosis, vascular anomalies and non-thrombotic mechanical causes such as strangulated hernia. Vasculitis is a common cause of mesenteric ischemia in younger people with auto-immune disease. . (Olson et al., 2018)