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Vascular Disorders

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Essential Medical Disorders of the Stomach and Small Intestine

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Abstract

Small intestinal vascular diseases are comprised of conditions, both anatomical and functional, that may result in compromised blood flow to segments of the small intestine, producing bowel ischemia and/or infarction. Etiologies of intestinal ischemia include acute mesenteric arterial ischemia, acute mesenteric venous ischemia, acute nonocclusive mesenteric ischemia, and chronic mesenteric ischemia. Despite advance in diagnosis and treatment, mortality rates remain high, particularly among patients with acute mesenteric ischemia, largely due to challenges in making a timely diagnosis. Prompt recognition of symptoms suggestive of intestinal ischemia, leading to early diagnostic and therapeutic intervention, remains the most important determinant of morbidity and mortality among patients with intestinal ischemia.

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Author information

Authors and Affiliations

  1. Duke University, Durham, NC, USA

    David A. Tendler

Authors
  1. David A. Tendler
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Corresponding author

Correspondence to David A. Tendler .

Editor information

Editors and Affiliations

  1. Mayo Clinic, Jacksonville, FL, USA

    Brian E. Lacy

  2. Mayo Clinic, Scottsdale, AZ, USA

    John K. DiBaise

  3. Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Mark Pimentel

  4. Leeds Teaching Hospitals NHS Trust, Leeds Gastroenterology Institute, Leeds, UK

    Alexander C. Ford

Self-Test

Self-Test

  • Question 1. Which of the following is a true statement pertaining to acute mesenteric ischemia?

    1. A.

      Patients with a history of myocardial infarction or atrial fibrillation are at increased risk for acute mesenteric venous thrombosis.

    2. B.

      Patients with acute mesenteric thrombosis rarely have gastrointestinal symptoms preceding the acute event.

    3. C.

      The mortality rates of acute mesenteric ischemia due to mesenteric venous thrombosis are more favorable than other forms of acute mesenteric ischemia.

    4. D.

      Barium upper gastrointestinal exam is helpful in making the diagnosis of mesenteric ischemia.

  • Question 2. Patients with chronic mesenteric ischemia classically present with which of the following symptom complexes?

    1. A.

      Abdominal pain and bloating relieved by defecation

    2. B.

      Postprandial abdominal pain, aversion to eating, and weight loss

    3. C.

      Night sweats, chills, and bloody diarrhea

    4. D.

      Abdominal distention, confusion, and hematemesis

  • Question 3. A patient presenting with a proximal small bowel obstruction due to SMA syndrome is most likely to have experienced which of the following?

    1. A.

      Recent use of oral contraceptive pills

    2. B.

      A family member with a history of pulmonary embolism

    3. C.

      Prior umbilical hernia repair

    4. D.

      Significant weight loss following several courses of chemotherapy

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Tendler, D.A. (2019). Vascular Disorders. In: Lacy, B., DiBaise, J., Pimentel, M., Ford, A. (eds) Essential Medical Disorders of the Stomach and Small Intestine. Springer, Cham. https://doi.org/10.1007/978-3-030-01117-8_12

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  • DOI: https://doi.org/10.1007/978-3-030-01117-8_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-01116-1

  • Online ISBN: 978-3-030-01117-8

  • eBook Packages: MedicineMedicine (R0)

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