The mesenteric arteries bring blood to the intestines, large and small, but like other arteries that transport blood throughout the body they can harden or become blocked.
When these three major arteries narrow or become blocked, relief may come only through surgery.
There are two types of mesenteric artery disease:
Chronic mesenteric artery ischemia: A blockage, usually caused by hardening or narrowing of the arteries (atherosclerosis), that’s removed surgically.
Acute mesenteric artery ischemia: An emergency, usually requiring surgery to remove a blood clot or blockage in the small intestine.
Symptoms
Intestinal ischemia, when not enough blood reaches the intestines, can affect people in different ways.
Chronic mesenteric artery ischemia:
- Abdominal pain (after eating).
- Tenderness.
- Diarrhea.
- Nausea.
- Fever.
- Vomiting.
- Weight loss.
- Avoidance of food because of related pain.
Acute intestinal ischemia:
- Sudden, intense abdominal pain.
- Diarrhea.
- Blood in stool.
- Vomiting.
- Mental confusion in older adults.
Causes
Any narrowing, blockage or blood clot that diminishes blood flow through at least one of the mesenteric arteries to the intestines can cause intestinal ischemia.
With less blood (and oxygen) coming into your digestive tract, cells weaken and eventually die. Unchecked, the condition can cause infection and gangrene. In extreme cases, the damage might include a hole in the wall of the intestines. Without proper treatment, intestinal ischemia can be deadly.
Potential contributors to mesenteric ischemia:
Treatment
A doctor who suspects intestinal ischemia might order several diagnostic tests, among them:
- CT scans.
- MRI.
- Magnetic Resonance Angiography: an MRI of the blood vessels.
- Ultrasound.
- Arteriogram: X-rays and a dye that checks blood flow through the arteries.
- Endoscopy: a camera, inserted through the mouth, for a view of the upper region of the small intestine.
- Chronic mesenteric artery ischemia: If your intestines are not damaged, your doctor might prescribe anticoagulants for up to six months to prevent blood clots. Antibiotics are more appropriate if an infection causes a blockage in your intestinal arteries. If the arteries have narrowed, a vasodilator drug can widen them.
Lifestyle changes: A low-fat, low-sodium diet and regular exercise also can help if your arteries have narrowed or hardened. You doctor will likely recommend that you maintain healthful weight, control high blood pressure and high cholesterol and stop smoking. (Smoking narrows the arteries.)
When a narrowed artery requires surgery, angioplasty restores blood flow with a tube (stent) inserted into the artery to keep it open.
Acute mesenteric artery ischemia: Sudden abdominal pain is so severe that prescription narcotic medications might not ease it. With the threat of severe intestinal damage, emergency surgery is often the only solution – though doctors might prescribe thrombolytics if a blood clot is found. These drugs do, in fact, dissolve large bloods clots, but their use is restricted to life-threatening circumstances because they can cause sudden bleeding.
When the artery is beyond repair, surgeons can bypass it in an emergency procedure. An open mesenteric artery bypass, which requires an incision in the abdomen, risks significant damage to the intestines. The bypass, made from a vein or a synthetic material, is attached above and below the affected area.