Understanding Vascular Insufficiency of Intestine: Causes, Symptoms, and Management

What is it?

Vascular insufficiency of intestine, or intestinal ischemia refers to several conditions in which there is a decrease in blood flow to the small and/or large intestine. Intestinal ischemia is usually due to arterial blockage. It causes pain, loss of function and if left untreated may result in damage to intestinal tissue and death. Intestinal ischemia can develop in an acute or a chronic manner. It is typically divided into:
Colon ischemia which is the most common type, occurring due to a decrease in the colon blood flow. Conditions that may lead to ischemic colon are hypotension due to heart failure, surgery, trauma or shock, blood clot, volvulus or a trapping of the intestines due to an hernia, vasculitis and other diseases affecting blood vessels, medications that constrict blood vessels, hormonal medications and excessive exercise.
Acute mesenteric event affects the small intestine due to a clot that dislodges from the heart and blocks, typically, the superior mesenteric artery, a blockage in one of the main intestinal arteries or low blood pressure that results in impaired blood flow.
Chronic mesenteric ischemia, or mesenteric angina, is caused due to an accumulation of fatty deposits in the arteries- atherosclerosis. If a blood clot is formed in one of those arteries it could lead to an acute mesenteric event.
Ischemia due to problems in intestinal venous drainage can be caused due to pancreatitis, malignancy, abdominal infection, hypercoagulation disorders, medications such as estrogen and abdominal injuries.

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Additional names

This group contains additional names:
- Chronic ischemic colitis
- Chronic ischemic enteritis
- Superior mesenteric artery syndrome

Signs & symptoms

Symptoms of acute vascular insufficiency of the intestine may include abdominal pain, urgent need to have a bowel movement, frequent, forceful bowel movements, abdominal tenderness and distention, bloody stool and in the elderly, also confusion.
Symptoms of chronic vascular insufficiency of the intestine may include abdominal cramps, fullness that begins half an hour after eating, diarrhea, weight loss, nausea and bloating.

Diagnosis

Diagnosis of vascular insufficiency of the intestine is made upon findings in medical history and physical examination. Also, blood tests can suggest it and imaging tests help search for the reason and rule out other conditions. Endoscopy, angiography and exploratory surgery are other diagnostic tools.

Treatment

Treatment for colon ischemia is antibiotics to prevent or treat an abdominal infection. Then, the treatment will focus on the underlying condition. It can heal on its own but sometimes, if the tissue was damaged, a surgery will be necessary. In an acute or chronic mesenteric event, a surgery is done to remove the blood clot, repair or remove the damaged tissue or to bypass the blockage. A narrowed artery can be treated in angiography by placing a balloon and a stent. Venous thrombosis is treated with anticoagulants.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital