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| The nation's #1 heart program by U.S. News & World Report for 13 years in a row! |
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| Intestinal Ischemic Syndromes
Intestinal ischemic syndromes -- also called visceral or mesenteric ischemic syndromes -- occur when blood flow to the bowel or gastrointestinal system (intestines) is decreased because of a blood vessel blockage. The three major abdominal blood vessels that may become blocked include the celiac artery, superior mesenteric artery or inferior mesenteric artery. Usually two or three of these arteries must be narrowed or blocked to cause intestinal ischemic syndromes. What causes these syndromes?
The conditions also can be caused by blood clots or aneurysms (an abnormal enlargement or bulging) in the vessels. Are these conditions more common at a certain age? Intestinal ischemic syndromes are more common after age 60 but can occur at any age. Types of Intestinal Ischemic Syndromes Intestinal ischemic syndromes can occur suddenly (acute) or over time (chronic). Acute Mesenteric Ischemia The arteries supplying oxygen-rich blood and nutrients to your intestines can become narrowed from atherosclerosis in the same way that coronary (heart) arteries become narrowed in heart disease. Mesenteric ischemia can develop if the narrowing or blockage become severe. Another cause of mesenteric ischemia is a blood clot. If a blood clot forms or travels to the narrowed artery, the blood supply to the intestine is suddenly interrupted. The tissues below the blocked vessel will be starved for oxygen-rich blood and die. This event is a lifethreatening condition. Prompt diagnosis and treatment is necessary to save the patient’s intestine and life. What are the symptoms of acute mesenteric ischemia? Early signs and symptoms of acute mesenteric ischemia include:
How is acute mesenteric ischemia diagnosed? An arteriogram is used to diagnosis acute mesenteric ischemia. An arteriogram is an invasive test of the blood vessels in which dye is injected and x-ray pictures are obtained. Abdominal computed tomography (CT) scans and chest X-rays, as well as other tests, may be performed first to rule out other conditions that may have similar symptoms, such as a bowel obstruction. How is acute mesenteric ischemia treated? Emergency surgery may be performed to remove the blood clot (embolectomy) or bypass the blocked vessel and restore blood flow to the intestines. The surgeon may use autologous bypass grafts (patient’s own blood vessels) or artificial grafts. In some cases, the surgeon may need to remove a portion of the intestine if tissue death has occurred. Another option is the use of a “clot busting” medication. With the aid of an arteriogram, a clot-busting medication may be injected to break up the clot in the artery. Chronic Mesenteric Ischemia Chronic mesenteric ischemia is characterized by narrowing of the blood vessels that supply the intestines with nutrients and oxygen-rich blood. This narrowing also is caused by atherosclerosis (buildup of fatty matter and plaque on the blood vessel walls). Chronic mesenteric ischemia is more common in women than men, and occurs after age 60. What are the risk factors for chronic mesenteric ischemia? Just like any form of blood vessel disease, there are factors that increase the risk of developing chronic mesenteric ischemia. These include:
What are the symptoms of chronic mesenteric ischemia? The organs of the gastrointestinal system are involved with the digestion of food. Therefore, decreased blood supply to these organs will lead to symptoms related to eating or after-meal digestion, including:
How is chronic mesenteric ischemia diagnosed? Abdominal computed tomography (CT) scans, gastrointestinal X-rays and other tests may be performed first to rule out other conditions that may have similar symptoms, such as a bowel obstruction. Once chronic mesenteric ischemia is suspected, an arteriogram is used to confirm the diagnosis and to evaluate atherosclerosis inside the arteries. How is chronic mesenteric ischemia treated?
Follow-Up Care In addition to following a low-fat diet, eating small, frequent meals is recommended for patients with chronic mesenteric ischemia. Regular exercise, as well as managing blood pressure, cholesterol and diabetes, also are recommended. For more information, call the Heart Center Resource Nurse at 216/445-9288 or toll-free 866/289-6911 or E-mail e-mail us using the Contact Us form. We would be happy to answer your questions. ©Cleveland Clinic Foundation revised 8/07 |
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What
are intestinal ischemic syndromes?
In
most cases, intestinal ischemic syndromes are caused by atherosclerosis
(buildup of fatty matter and plaque on the blood vessel walls), leading
to narrowing or blockage of the vessel. 
Angioplasty
and stenting - A balloon catheter is used to attempt to open
the artery and a small stent is placed inside the artery to keep it
open.