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Harrison's Principles of Internal Medicine, 18e
| Part 14. Disorders of the Gastrointestinal System > Section 1. Disorders of the Alimentary Tract > |
Chapter 298. Mesenteric Vascular Insufficiency
Sections: Intestinal Ischemia, Acknowledgments, Further Readings.
Topics Discussed: gastrointestinal tract vascular insufficiency.
Excerpt:"Intestinal ischemia is an uncommon vascular disease associated with a high mortality. It is categorized according to etiology: (1) arterioocclusive mesenteric ischemia (AOMI), (2) nonocclusive mesenteric ischemia (NOMI), and (3) mesenteric venous thrombosis (MVT). Acute intestinal ischemia is more common than its counterpart, chronic arterial ischemia. Risk factors for acute arterial ischemia include atrial fibrillation, recent myocardial infarction, valvular heart disease, and recent cardiac or vascular catheterization. The increased incidence of intestinal ischemia seen in Western countries parallels the incidence of atherosclerosis and the aging population. With the exception of strangulated small-bowel obstruction, ischemic colitis is the most common form of acute ischemia and the most prevalent gastrointestinal disease complicating cardiovascular surgery. The incidence of ischemic colitis following elective aortic repair is 5–9%, and the incidence triples in patients following emergent repair. Other less common forms of intestinal ischemia include chronic mesenteric angina associated with atherosclerotic disease and MVT. The latter is associated with the presence of a hypercoagulable state including protein C or S deficiency, antithrombin III deficiency, polycythemia vera,..."
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