Acute mesenteric ischemia (AMI) or mesenteric infarction-colloquially called intestinal infarction (synonyms: Mesenteric artery occlusion, mesenteric occlusive disease, angina abdominalis; thesaurus synonyms: Acute intestinal vascular disease; acute intestinal ischemia; acute intestinal necrosis; acute small bowel ischemia; acute fulminant ischemic colitis; acute intestinal necrosis; acute intestinal ischemia; acute mesenteric ischemia; acute ischemic enteritis; acute ischemic enterocolitis; acute ischemic colitis; acute mesenteric ischemia; acute intestinal infarction; acute intestinal infarction; angina abdominalis; arterial mesenteric vascular thrombosis; arterial mesenteric infarction; intestinal artery embolism with gangrene; intestinal artery thrombosis; intestinal gangrene; intestinal vessel infarction; intestinal necrosis; intestinal thrombosis with gangrene; intestinal vein embolism with gangrene; intestinal wall gangrene; Intestinal wall necrosis; Colonic necrosis; Small intestinal gangrene; Small intestinal infarction; Small intestinal necrosis; Embolism of mesenteric artery; Embolism of superior mesenteric artery; Embolism of mesenteric vessel; Enterocolitis fulminans; Fulminant ischemic enterocolitis; Hemorrhagic intestinal necrosis; Hemorrhagic intestinal necrosis; Ileal necrosis; Infarction of a mesenteric vessel; Intestinal gangrene; Intestinal thrombosis with gangrene; Intestinal necrosis; Colonic gangrene; Colonic infarction; Colonic necrosis; Massive hemorrhagic gangrene of the intestine; Mesenteric artery embolism; Mesenteric artery embolism with gangrene; Mesenteric artery thrombosis; Mesenteric artery occlusion; Mesenteric embolism; mesenteric occlusive disease; mesenteric gangrene; mesenteric vessel occlusion; mesenteric infarction; mesenteric ischemia; mesenteric necrosis; mesenteric thrombosis; mesenteric vein embolism; mesenteric vein embolism with gangrene; Mesenteric vein thrombosis; Omental thrombosis with gangrene; Omental infarction; Omental necrosis; Peritoneal necrosis; Subacute ischemic colitis; Thrombosis of mesenteric arteries with gangrene; Occlusion of mesenteric artery; ICD-10 K55. 0) refers to acute occlusion of the blood vessels supplying the intestine. It is the final stage of abdominal arterial occlusive disease.
The following forms of mesenteric ischemia can be distinguished:
- Arterial occlusive ischemia – occlusion of an artery (the superior mesenteric artery (AMS) is involved in 85% of all cases) by an embolus (arterial embolism) or by thrombosis.
- Arterial non-occlusive ischemia (NOD; Non – Occlusive – Disease) – ischemia (reduced supply) due to cardiovascular disturbances (e.g., due to a drop in cardiac output, HZV) with reactive vasospasm in the mesenteric stromal area (area of the vessels supplying the intestine)
- Venous – Thrombosis of the mesentericoportal axis (a vein supplying the intestine).
Mesenteric ischemia is a vascular (vessel-related) emergency and must be treated immediately. The ischemia tolerance of the intestine is only 6 hours!
Sex ratio: males and females are equally affected.
Frequency peak: The average age is about 70 years.
Approximately one percent of patients with acute abdomen present with acute mesenteric ischemia. In individuals > 70 years of age, this number is up to ten percent.
The incidence (frequency of new cases) is approximately 10 cases per 100,000 population per year.
Course and prognosis:Course and prognosis depend on the promptness of diagnosis (4-6 hours after symptom onset) and adequate therapy.Peripheral arterial mesenteric ischemia (AMI) is associated with lower lethality compared to central occlusion (occlusion).Because of the uncharacteristic clinical symptoms, the non-occlusive form (NOD) of AMI has a worse prognosis than the occlusive form.
The lethality (mortality relative to the total number of people with the disease) ranges from 50% to 70%.
