- Acute intestinal ischemia - causes
- Acute intestinal ischemia - symptoms
- Acute intestinal ischemia - diagnosis, diagnosis
- Acute intestinal ischemia - treatment
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Acute intestinal ischemia is caused by a sudden restriction of the mesenteric arteries that supply blood to the intestines, or a reduction in intestinal perfusion. This condition is manifested by severe abdominal pain, especially around the navel. May cause intestinal necrosis.
Acute intestinal ischemiais a dangerous condition for the patient. It can lead to intestinal necrosis, a complication of which is intestinal perforation leading to widespread peritonitis with very high mortality. There are two types of acute intestinal ischemia: acute intestinal ischemia with obstruction of the visceral arteries and acute intestinal ischemia without obstruction of the visceral arteries.
Acute intestinal ischemia - causes
Acute intestinal ischemia with obstruction of the visceral arteries can be caused by embolism resulting from, for example, atrial fibrillation, a recent heart attack or heart failure. Thrombosis, which occurs as a result of blood clotting on the plaque, can also close the world of the artery.
Acute intestinal ischemia without obstruction of the visceral arteries occurs as a result of spasm or decreased inflow into the visceral arteries induced by drugs such as cocaine, vasopressin, or noradrenaline. Such effects can also be obtained from the intestinal revascularization procedure.
Good to know: Intestinal obstruction - symptoms, causes and treatment
Acute intestinal ischemia - symptoms
Acute intestinal ischemia is manifested by severe abdominal pain, usually around the navel, often not amenable to opioid treatment. You may experience vomiting or diarrhea with mucus and blood in the stools as a result of increased motility, but this stops over time.
Initially, the examination may not show any characteristic symptoms, but after bowel perforation, symptoms of diffuse peritonitis appear, such as increased temperature, pale skin, increased but barely perceptible heart rate, a clothed and dry tongue, and shallow breathing. The belly is hard and very painful.
There is abdominal distension and troublesome hiccups. Diffuse peritonitis is a life-threatening condition.
Acute intestinal ischemia - diagnosis, diagnosis
In diagnosticsFor acute intestinal ischemia, computed tomography of blood vessels (angio-CT) is used to distinguish between embolic and thrombotic origins. Arteriography, which consists in taking X-rays after the administration of contrast material to the vessel, is used in the event of an ambiguous CT-angio test result.
Abdominal X-ray may also be performed to exclude intestinal perforation and obstruction. Laboratory test changes include elevated leukocytes, elevated lactate levels, and increased amylase levels.
Acute intestinal ischemia - treatment
Treatment of acute intestinal ischemia due to arterial occlusion may be endovascular or operative. Endovascular treatment consists of local thrombolysis, which consists of administering a drug to dissolve the clot directly in the vicinity of the clot, or percutaneous thrombectomy.
The percutaneous thrombectomy procedure consists in inserting a catheter into the vessel and under the control of the X-ray image and the contrast of the thrombus puncture and its aspiration into the catheter. Balloon angioplasty may also be used in this type of treatment, during which a balloon is inserted into the vessel on the catheter, causing the vessel to widen.
Surgical treatment includes embolectomy in the case of embolism and thrombectomy and bypass anastomosis in the case of thrombosis.
Embolectomy involves opening an arterial vessel and removing the blockage.
In acute intestinal ischemia without arterial obstruction, treatment consists of administering a vasodilating drug to the contracted artery via a vascular catheter. It is also extremely important to treat patients with shock.