ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferencesView all Images (6)
Potentially life-threatening emergency
Acute mesenteric ischemia
Print Captions
Other Resources UpToDate PubMed
Potentially life-threatening emergency

Acute mesenteric ischemia

Print Images (6)
Contributors: Michael W. Winter MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Alerts and Notices

Synopsis

Acute mesenteric ischemia : Nausea/vomiting, Diffuse abdominal pain, Metabolic acidosis, Pain out of proportion to exam findings, Periumbilical pain, WBC elevated
Acute mesenteric ischemia is the acute insufficiency of small bowel blood supply leading to bowel ischemia. It can progress to bowel perforation, severe sepsis, and death. Acute arterial obstruction is caused either by an embolism or thrombus in the setting of atherosclerosis. Hypoperfusion in the setting of severe hypotension or low flow states may also cause acute mesenteric insufficiency in the absence of occlusive disease.

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

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

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

Subscription Required

Last Reviewed:12/26/2017
Last Updated:09/16/2020
Copyright © 2021 VisualDx®. All rights reserved.
Potentially life-threatening emergency
Acute mesenteric ischemia
Captions Print   View all Images (6)
(with subscription)
Acute mesenteric ischemia : Nausea/vomiting, Diffuse abdominal pain, Metabolic acidosis, Pain out of proportion to exam findings, Periumbilical pain, WBC elevated
Imaging Studies image of Acute mesenteric ischemia
Enhanced CT scan of the abdomen showing low attenuation wall thickening throughout the small bowel with mesenteric edema and decrease in wall enhancement. These findings are consistent with diffuse extensive ischemia of the small bowel.

+4 More images of Acute mesenteric ischemia with subscription

Copyright © 2021 VisualDx®. All rights reserved.