Mesenteric Ischemia - Medical Malpractice Lawyers

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Mesenteric Ischemia - Medical Malpractice

Mesenteric ischemia is not that common but, when it occurs, it can be lethal. It occurs when the arteries that supply the blood to the small and large intestines become affected by atherosclerosis and the circulation to the abdominal contents is diminished. Blood can't flow through the superior mesenteric artery or through the inferior mesenteric arteries (or both), leading to ischemia or lack of circulation to the small or large intestines so that there is pain and other symptoms. The circulation to the liver, stomach, gallbladder and colon can all be affected by this disease.

The pain can be relatively severe and is worse after eating. The blockage can get worse and the intestinal tissues die off and can rupture, leading to peritonitis and sometimes death. It is most common in those older than the age of 60 and is more common if you smoke or have an elevated cholesterol level.

You can have either acute or chronic mesenteric ischemia. Chronic ischemia leads to intermittent abdominal pain with eating and does not usually lead to death of a part of the intestines until it becomes severe. Acute mesenteric ischemia causes sudden abdominal pain and is very serious. Chronic mesenteric ischemia can worsen to become acute mesenteric ischemia so you need to watch out, even if your condition is considered chronic.

The main symptoms of metabolic syndrome include pain in the abdomen about 15 to 60 minutes after eating a meal. The pain is usually in the central or upper part of the abdomen and it lasts as long as 90 minutes until it disappears. It comes back when you eat again. People often lose weight after developing the condition because eating makes their symptoms worse and they avoid eating.

The symptoms can also be elusive and can mimic other medical conditions. More rare symptoms of the disease include nausea, vomiting, flatulence, diarrhoea or constipation. The pain may not get any better with narcotic pain medications and you will often feel nausea and vomiting with the pain.

The cause of mesenteric ischemia is atherosclerosis, which slows the amount of blood that flows through your arteries. The lack of blood flow means poor circulation and pain to the affected area of the bowels or stomach so that you have problems eating. Plaque builds up along the arterial wall and cuts off the circulation to the crucial aspects of the intestinal tract required for absorption and digestion of food. A clot can form within the narrowed artery and cause acute blockage of the mesenteric arteries with sudden severe pain that does not let up. This can become associated with congestive heart failure, low blood pressure, aortic dissection or blockage of the veins in the bowel area. Coagulation problems can contribute to mesenteric ischemia and conditions affecting the blood vessels such as arteritis can contribute to having mesenteric ischemic problems.

Mesenteric ischemia is a serious disease, which, if acute, can be lethal. It can cause the bowels to dilate and rupture due to lack of circulation. This causes peritonitis and bacteria in the bloodstream-a deadly condition that requires ICU support and antibiotics.

The doctor will perform a few tests to see if you have mesenteric ischemia. Blood will be checked for an elevated white blood cell count and the doctor will ask about your smoking history and other health history questions will be asked. The examination of the abdomen is important because it can show tenderness in the epigastrium (upper abdomen) or the middle of the abdomen. An angiogram of the abdomen is the ultimate test needed to see what the circulation is like in the bowels. A Doppler ultrasound is a less invasive test that can check if the circulation in the bowels is normal or not. A CT scan can show a three dimensional image of the abdomen, including what's going on with the major arteries of the abdomen.

The treatment of mesenteric ischemia is to open the affected artery so circulation is better to the intestines. You need to have this happen before there is permanent damage to the colon or small intestines. One treatment is called a trans-aortic endarterectomy that removes the plaque from the artery in a relatively non-invasive way. Angioplasty and stenting open of the artery is one of the latest treatments for mesenteric ischemia. It keeps the blood vessel open for the long haul. If parts of the intestines are damaged beyond repair, these parts of the intestine must be removed in order to save the person's life.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here