Skip to main content

Ischemic Bowel Disease-Causes-Signs-Symptoms-Treatment


Ischemic Bowel Disease:
Ischemia means a decrease in blood supply (blood flow) to an organ, tissue or part of the body. For example, cerebral ischemia means a decrease in blood supply to the brain.
Maintenance of adequate blood flow is very important for correct and functioning and survival of an organ.
Adequate blood supply provides oxygen and nutrients to the tissue and also removes waste materials from the site of formation. Inadequate blood flow or ischemia compromises the function of the organ because the organ is not getting enough nutrients and accumulation of toxic wastes destroy the function of the organ. If blood supply continues to decrease and ischemia is not correct, the organ may die.
Maintenance of adequate blood flow is important. Because in some cases there is normal arterial blood supply but there is an obstruction in venous return. Therefore, blood won't flow through the vessels and this also results in ischemia.

Ischemic bowel disease is the disease of bowel (intestine) or pathological changes in intestines that results from ischemia (decreased blood supply).

Intestinal Blood Supply:


Arterial Blood Supply:

- Celiac artery
-  the first portion of the duodenum
- Superior mesenteric artery
the remainder of the small bowel and the large bowel up to the splenic flexure
Inferior mesenteric artery –
the remainder of the large bowel and part of the rectum
Branches of the internal iliac artery

- distal rectum


Venous Drainage
The hepatic portal circulation carries venous blood from the gastrointestinal organs and spleen to the liver.
Eventually, blood leaves the sinusoids of the liver through the hepatic veins which drain into the inferior vena cava.
Predisposing Factors:

Age (older than 50)
More frequent in women
High blood pressure (hypertension).
Diabetes
High cholesterol
Smoking
History of heart attack
Stroke


Causes:
        vascular occlusion (Arterial)

Atherosclerosis
Aortic aneurysm.
Embolization of cardiac vegetations or aortic atheromas.

vascular occlusion (Venous)
lHypercoagulable states.
lInvasive neoplasms.
lCirrhosis.
lTrauma
lAbdominal masses compressing portal drainage.

Intestinal hypoperfusion.
lShock.
lDehydration.
lSystemic vasculitis

Pathogenesis:


lIschemic lesion may be restricted to the small or large intestine or may affect both, depending on the particular vessel or vessels involved.
lSeverity of ischemic damage also depends on time frame of occlusion (acute or chronic) and degree of vascular compromise.
lThe severity of the injury ranges from:
lTransmural infarction of the gut, involving all visceral layers, to
lMural infarction of the mucosa and submucosa , sparing the muscular wall, to
lMucosal infarction, Just mucosa is involved
severity of infarction depends upon the level of blood supply compromise.


Signs And Symptoms:

lNausea
lVomiting
lFatigue
lTransient bloody Diarrhea
lLow-grade fever
lAbdominal pain, tenderness
   or cramping 
lMinimal abdominal distention
lHypoactive bowel sound

Treatment
Treatment depends on the cause of ischemic bowel disease.

Treatment options for mild ischemic bowel disease include:
Anticoagulant medications:
Heparin
Warfarin (Coumadin)
Angioplasty for bowel ischemia
To open the artery that supplies the intestine

Treatment options for life-threatening ischemic bowel disease include:
Papaverine injection for bowel ischemia
Dilates the arteries supplying blood to the intestine
Surgery for bowel ischemia:
To open the artery that supplies the intestine

References:
* Robins Basic Pathology
* Freemd.com
Visit Home page

Popular posts from this blog

Human Parasites, Types of Parasites, and Classification

Parasite: A parasite is a living organism which gets nutrition and protection from another organism where it lives. Parasites enter into the human body through mouth, skin and genitalia. In this article, we will generally discuss the types and classification of parasites. It is important from an academic point of view. Those parasites are harmful, which derives their nutrition and other benefits from the host and host get nothing in return but suffers from some injury. Types of Parasites Ecto-parasite: An ectoparasite lives outside on the surface of the body of the host. Endo-parasite: An endo-parasite lives inside the body of the host, it lives in the blood, tissues, body cavities, digestive tract or other organs. Temporary parasite: A temporary parasite visits its host for a short period of time. Permanent parasite: Permanent parasite lives its whole life in the host. Facultative parasite: A facultative parasite can live both independently and dependently. It lives in the...

IELTS or OET - Reviews - Personal Experience - Which to Choose - IETLS vs OET

OET and IELTS both are used to assess the knowledge of English Language. The basic difference between the above two is this, IETLS is a more generalized English language assessment test, on the other hand, OET is profession specific. For example, if you are a doctor, the content of the test will be related to your occupation. Because of this, the OET is being chosen by many healthcare professional instead of IELTS. Both tests have the same sub-categories, that is listening, speaking, writing and reading. Lets us discuss the differences one by one. TEST OET IELTS OET Compared to IELTS is ………. (Author’s opinion) Speaking You will need to do two role plays. You will be given a situation and asked to counsel the patient about a disease and treatment or break the bad news. It has 3 parts, first is an introduction and general question, In the second part you will be provided with a topic to speak for 2 minutes. In the 3rd part, you will b...