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Mesenteric ischaemia 

Mesenteric ischaemia
Chapter:
Mesenteric ischaemia
Author(s):

James E. Coulston

and Peter M. Lamont

DOI:
10.1093/med/9780199658220.003.0065
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date: 15 September 2019

Mesenteric ischaemia encompasses a number of uncommon, but important, clinical conditions that can cause impairment to the splanchnic circulation as well as bowel ischaemia and infarction, and are best classified as acute or chronic and arterial or venous. One unifying feature of mesenteric arterial and venous disease is the clinical uncertainty due to the lack of clinical signs. This combined with the condition’s rarity means a high index of suspicion must be kept to ensure prompt intervention prior to significant harm. Delays in diagnosis of acute mesenteric ischaemia are associated with significant morbidity and mortality; the presence of frank bowel infarction increases mortality rates significantly. Chronic arterial ischaemia has a significant impact on quality of life, and the key is early recognition prior to the development of serious malnutrition. Patient history is fundamental, and revascularization should only be undertaken if there is agreement between the clinical history and the investigations.

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