Acute Mesenteric Ischemia

At first, the person has severe abdominal pain Acute Abdominal Pain Abdominal pain is common and often minor. Severe abdominal pain that comes on quickly, however, almost always indicates a significant problem. The pain may be the only sign of the need for surgery... read more that usually develops suddenly. However, the person usually has only mild pain when the doctor presses on the abdomen during the examination (unlike in disorders such as appendicitis or diverticulitis, in which pressing makes the pain much worse).

Later, as the intestine starts to die, the doctor's examination of the abdomen causes more severe pain.

If the person has typical symptoms of acute mesenteric ischemia or if the abdomen is very tender, doctors usually take the person right to surgery.

If the diagnosis of acute mesenteric ischemia is not clear, doctors do CT angiography CT angiography Computed tomography (CT) is a type of medical imaging that combines a series of x-rays to create cross-sectional, detailed images of internal structures. In computed tomography (CT), which used... read more or mesenteric angiography to look for blockages in the arteries that supply blood to the intestines. In CT angiography, CT (computed tomography) and a radiopaque dye that is injected in an arm vein are used to produce images of blood vessels. In mesenteric angiography, a small flexible tube (catheter) is threaded through the artery in the groin and into the arteries of the intestines. A radiopaque dye is injected through the catheter to make the arteries easier to see on x-rays that are taken at the same time. Magnetic resonance angiography Magnetic resonance angiography (MRA) Magnetic resonance imaging (MRI) is a type of medical imaging that uses a strong magnetic field and very high frequency radio waves to produce highly detailed images. During an MRI, a computer... read more is another kind of angiography that may be done to provide detailed images of blood vessels.

X-rays X-Rays X-rays are a type of medical imaging that use very low-dose radiation waves to take pictures of bones and soft tissues. X-rays may be used alone (conventional x-ray imaging) or combined with... read more or magnetic resonance imaging Magnetic Resonance Imaging (MRI) Magnetic resonance imaging (MRI) is a type of medical imaging that uses a strong magnetic field and very high frequency radio waves to produce highly detailed images. During an MRI, a computer... read more (MRI) of the abdomen are other tests that may be done.

If mesenteric ischemia is diagnosed during surgery, the blood vessel blockage can sometimes be removed or bypassed, but other times the affected intestine must be removed.

If mesenteric ischemia is diagnosed during CT angiography or mesenteric angiography, doctors may try to relieve the blockage in the blood vessels using angioplasty and placement of a stent. In angioplasty, a small flexible tube (catheter) is threaded through the artery in the groin and into the arteries of the intestines, and angiography is done. If a blockage is seen, sometimes it can be opened by injecting certain medications, suctioning out a blood clot using a special angiography catheter, or inflating a small balloon within the artery to widen it and then placing a small tube or manufactured mesh (a stent) to keep it open. If doctors cannot successfully open the blockage using these procedures, the person needs surgery to open the blockage or to remove the affected portion of the intestine.

After recovery, many people need to take a medication to help prevent blood clotting.

If the doctor can make the diagnosis and begin treatment early, people usually recover well.

If the diagnosis is not made or if treatment is not started until some of the affected intestine has died, 70 to 90% of people die. A person cannot survive if almost all the small intestine dies or is removed.