intestinal ischemia and infarction is damage to (ischemia) or death of (infarction) part of the intestine due to a decrease in its blood supply.
CausesThere are several possible causes of intestinal ischemia and infarction.Hernia: If the intestine moves into the wrong place or becomes tangled, this can lead to intestinal ischemia.
Adhesions: The intestine may become trapped in scar tissue from past surgery (adhesions). This can lead to ischemia if left untreated.
Embolus: A blood clot from the heart or main blood vessels may travel through the bloodstream and block one of the arteries supplying the intestine. People who have had a heart attack or who have arrhythmias, such as atrial fibrillation, are at risk for this problem.
Arterial thrombosis: The arteries that supply blood to the intestine may become so narrowed fromatherosclerotic disease (cholesterol buildup) that they become blocked. When this happens in the arteries to the heart, it causes a heart attack. When it happens in the arteries to the intestine, it causes intestinal ischemia.
Venous thrombosis: The veins carrying blood away from the intestines may become blocked by blood clots. This blocks blood flow into the intestines. This is more common in people with liver disease, cancer, or blood clotting disorders.
Low blood pressure: Very low blood pressure in patients who already have narrowing of the intestinal arteries may also cause intestinal ischemia. This typically occurs in patients who are very ill for other reasons. It can be compared to losing water pressure in a hose with a partial blockage.
SymptomsThe hallmark symptom of intestinal ischemia is abdominal pain. Other symptoms include:Other tests include:
None of these tests are foolproof, however. Sometimes the only sure way to diagnose intestinal ischemia is with a surgical procedure.
TreatmentTreatment usually requires surgery. The section of intestine that has died is removed, and the healthy remaining ends of bowel reconnected.In some cases, a colostomy or ileostomy is needed. The blockage of arteries to the intestine is corrected, if possible.
Outlook (Prognosis)Intestinal ischemia is a serious condition that can result in death if not treated promptly. The outlook depends on the cause. A good outcome may be achieved with prompt treatment. Possible ComplicationsIntestinal infarction may require a colostomy or ileostomy, which may be short-term or permanent. Peritonitis is common in these cases.Some people may develop severe illness, with fever and a bloodstream infection (sepsis).
When to Contact a Medical ProfessionalCall your health care provider if you have any severe abdominal pain. PreventionPreventive measures include:heart attack
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