Intestinal Ischaemia

A condition characterised by reduced blood flow to the intestines, leading to tissue damage and potentially cell death.

• Arterial embolism, commonly originating from the heart (e.g., atrial fibrillation).
• Arterial thrombosis in existing atherosclerotic vessels.
• Nonocclusive mesenteric ischaemia: Resulting from low blood flow states such as shock or heart failure.
• Venous thrombosis, often due to hypercoagulable states or inflammation.

• Sudden onset of severe abdominal pain, often out of proportion to physical findings.
• Initial pain may be colicky, progressing to a constant pain.
• Nausea, vomiting, and diarrhoea.
• Later stages: Bloody stools, signs of peritonitis, and septic shock.

• Acute pancreatitis
• Peptic ulcer disease
• Cholecystitis
• Diverticulitis

• Lactate level: Elevated in ischaemic conditions.
• Full Blood Count (FBC): Leucocytosis suggesting inflammation or infection.
• CT angiography: Gold standard for visualising blood flow in mesenteric vessels.
• Doppler ultrasound: Useful for assessing blood flow.
• Plain X-rays: May show signs of bowel obstruction or pneumatosis intestinalis (air within the bowel wall).

• Immediate resuscitation with fluids and correction of any electrolyte imbalances.
• Surgical intervention to restore blood flow, resect necrotic bowel, and prevent or treat complications.
• Anticoagulation in venous thrombosis cases.
• Antibiotics to prevent or treat secondary infections.

• Peritonitis: Inflammation of the inner lining of the abdominal wall.
• Septic shock: Severe drop in blood pressure due to a widespread infection.
• Short bowel syndrome: Resulting from extensive resection of the intestines.
• Multiple organ dysfunction syndrome (MODS).