Mesenteric ischaemia

Mesenteric ischaemia is primarily caused by arterial embolism resulting in infarction of the colon. It is more likely to occur in areas such as the splenic flexure that are located at the borders of the territory supplied by the superior and inferior mesenteric arteries.

Predisposing factors

• increasing age
• atrial fibrillation
• other causes of emboli: endocarditis
• cardiovascular disease risk factors: smoking, hypertension, diabetes
• cocaine: ischaemic colitis is sometimes seen in young patients following cocaine use

Features

• abdominal pain
• rectal bleeding
• diarrhoea
• fever
• bloods typically show an elevated WBC associated with acidosis

Management

• supportive care
• laparotomy and bowel resection