Mesenteric Ischemia

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Introduction

Inferior mesenteric artery (IMA) is often the first to go, as it is lower down and can become involved in aortoiliac disease.

It can also be tied off during surgery, with little initial consequences.

postprandial abdominal pain

weight loss

nausea and vomiting

food avoidance

SB ischemia can present as sudden, severe pain. It is steady.

Negative on scopes

Often two vessels are occluded and the other stenosed

Minimally invasive, endovascular approaches can be taken by interventional radiologists or vascular surgeons.

Open repair

more durable and with higher clinical success
longer length of stay
more risk of complications
diarrhea can be disastrous if approaching anteriorly due to disruption of the celiac plexus
retrograde approach can be valuable for avoiding complications, traveling alongside the 11th rib.

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