Potentially life-threatening emergency
Acute mesenteric ischemia
Alerts and Notices
Synopsis

Symptoms are characterized by acute onset of abdominal pain, often out of proportion to the examination. In critically ill patients who may not be able to communicate, worsening pressor requirements, rising lactates, and abdominal distension or feeding intolerance should raise suspicion for mesenteric ischemia. Risk is increased in patients with risk for thromboembolic cardiac disease: patients with diabetes, peripheral artery disease, history of hypertension, hyperlipidemia, and who smoke.
Acute mesenteric ischemia is a medical emergency. Prompt diagnosis and intervention are necessary to re-establish blood flow to the intestine. Morbidity and mortality increases with delayed revascularization.
Related topic: Chronic mesenteric ischemia
Codes
ICD10CM:K55.9 – Vascular disorder of intestine, unspecified
SNOMEDCT:
91489000 – Acute vascular insufficiency of intestine
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Malrotation / volvulus
- Ruptured aortic aneurysm
- Vasculitis
- Chronic mesenteric ischemia
- Peptic ulcer disease
- Gastroesophageal reflux disease
- Gastritis
- Infectious colitis (eg, amebic colitis, Clostridium difficile colitis)
- Inflammatory bowel disease (eg, Crohn disease, ulcerative colitis)
- Malignancy
- Pancreatitis
- Choledocholithiasis
- Biliary colic
- Cholecystitis
- Constipation (eg, drug-induced constipation)
- Pancreatic cancer
- Hepatitis
- Pericarditis
- Angina (cardiac) (see acute coronary syndrome, coronary artery disease)
- Achalasia
- Bowel obstruction (see small bowel, large bowel)
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:12/26/2017
Last Updated:09/16/2020
Last Updated:09/16/2020
Potentially life-threatening emergency
Acute mesenteric ischemia
