Abstract
Intestinal ischemia (II), acute and chronic, are often related to older age and risks for thromboembolic disorders. In addition to cigarette smoking, hyperlipidemia, diabetes, and hypertension, other cardiovascular diseases are predisposing factors. The presentations, treatment, and prognosis of II depend primarily on the type of ischemic disorder. The two major types of II are ischemic colitis (IC), more frequent and with an overall better prognosis, and mesenteric ischemia (MI), less recurrent, with a much worse prognosis.
Ischemic colitis, more often involving the splenic flexure and the descending colon, is the result of a transient mismatch between colonic blood flow and the metabolic demands of the colon. Left-sided IC, in contrast to the rare type of right-sided disease, is a reversible condition with a very low mortality rate. Right-sided ischemic colitis is a severe disease with a different course and management.
MI may be acute or chronic, embolic or thrombotic, arterial, or venous. Acute mesenteric ischemia (AMI) is a vascular emergency, as a result of small intestinal hypoperfusion and infarction that arises from interruption of blood flow within the superior mesenteric artery or vein and has a catastrophic clinical course. The high mortality rate is related to the nonspecific symptoms, lack of diagnostic serological markers, difficulty, and associated delay in diagnosis, all causing rapid tissue deterioration.
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Pitchumoni, C.S. (2021). Intestinal Ischemia. In: Pitchumoni, C.S., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-030-30192-7_65
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