Dr. Jenny Gandhi

702, 7th Floor, Solaris Kode, Near Khatu Shyam Temple, VIP Road, Vesu , Surat.
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Mesenteric Ischemia

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Mesenteric Ischemia

+91 90033 03373

Mesenteric Ischemia

Home

Mesenteric Ischemia

WHAT IS
MESENTERIC ISCHEMIA?

Acute, excruciating abdominal pain may result from mesenteric ischemia, which is a blockage of blood flow to the intestines. Weight loss and digestive symptoms are possible outcomes of chronic cases. Emergency revascularization or surgery is necessary in acute cases.

causes

Atherosclerosis
Blood clots (Emboli)
Vasospasm
Low blood pressure
Thrombosis of the mesenteric veins
External compression

symptoms

Sudden, severe abdominal pain
Nausea and vomiting
Urgent need to pass stool or sudden
Blood in the stool or gastrointestinal bleeding
Fever, rapid heart rate, low blood pressure
Abdominal distention and eventual signs of peritonitis
Confusion or altered mental status in severe cases

if untreated?

Irreversible intestinal damage
Necrosis, or the death of intestinal tissue due to a lack of blood flow, may necessitate immediate surgery to remove the dead tissue.
Sepsis
A potentially fatal systemic reaction with multiple organ failure can result from bacterial infection that spreads as a result of bowel death.
Peritonitis
Severe infection caused by inflammation of the abdominal lining as a result of bowel perforation.
Death
With rates ranging from 50 to 80%, postponing treatment considerably raises the risk of death, particularly in cases of acute mesenteric ischemia.
Chronic complications
If left untreated, chronic mesenteric ischemia can lead to severe weight loss and malnutrition as a result of food avoidance brought on by pain.
Acute mesenteric ischemia progression
Acute mesenteric ischemia can become life-threatening when chronic symptoms abruptly worsen.

diagnosis

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Physical examination and history
  • centered on acute or persistent stomach pain, typically associated with eating, and related symptoms.
Arterial Doppler Ultrasound
  • A non-invasive procedure that uses sound waves to assess mesenteric artery blood flow and identify occlusion or stenosis.
Computed Tomography Angiography (CTA)
  • The widely used gold standard non-invasive imaging technique known as computed tomography angiography (CTA) visualizes the mesenteric vessels, evaluates blood flow, and looks for signs of bowel ischemia using X-rays and contrast dye.
Magnetic Resonance Angiography (MRA)
  • A radiation-free substitute for CTA that images mesenteric arteries using magnetic fields and contrast agents.
Conventional Angiography
  • This invasive test, which involves inserting a catheter and injecting contrast dye into the mesenteric arteries to detect blockages, is thought to be the gold standard for diagnosis. Additionally, it permits concurrent treatment interventions.
Laboratory Tests
  • Elevated lactate levels in blood can be a sign of tissue hypoxia, changes in the white blood cell count, or indicators of organ dysfunction and inflammation.
Abdominal X-rays
  • Although they are less sensitive, abdominal X-rays may reveal indications of bowel obstruction or perforation in more severe cases.

Interventional Radiology
treatment

Angioplasty

The purpose of angioplasty is to restore blood flow, alleviate symptoms (such as claudication), and promote wound healing in ischemic limbs. A thin catheter with a small deflated balloon at its tip is guided to the narrowed peripheral artery under X-ray guidance, the balloon is inflated to compress plaque against the artery wall and widen the lumen, and the balloon is then deflated and removed.
Atherectomy

To remove the blockage, the plaque accumulation on the arterial walls is physically removed or shaved off using a catheter-based device. To increase vessel patency, atherectomy can be used either by itself or in conjunction with angioplasty, particularly for complex or highly calcified lesions.
Drug‑Eluting Balloon (DEB) Angioplasty

Compared to plain balloon angioplasty, drug-eluting balloon angioplasty is more effective in small distal vessels and in-stent restenosis because it lowers the risk of restenosis by coating the balloon surface with an anti-proliferative drug (usually paclitaxel or other agents) that is transferred to the vessel wall during inflation.

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