Acute Mesenteric Ischemia

Causes

• Embolic (arterial embolism - ~50% of cases) - SMA most common site
  
• Dysrhythmias (especially atrial fibrillation), myocardial infarction, rheumatic heart disease, aortic aneurysm, cardiac surgery, angiography, and endocarditis
• Thrombosis (arterial thrombosis - 20% of cases) - SMA most common site
  
• Atherosclerosis
• Non-occlusive (25% of cases)
• Low flow states - CHF, shock
• Venous (5% of cases)
  
• SMV occlusion

Diagnosis

• CT-angiography is current gold standard
  

Treatment

• IVF to maintain BP
• Abx
• Heparin
• Papaverine (vasodilator)
  
• Lytics
• Surgery / Endovascular