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MESENTERIC ARTERY DISEASE

Mesenteric ischemia is a chronic condition caused by poor blood supply to your intestines. It results from narrowing in one or more of the arteries supplying blood to your intestines (visceral arteries). It also can occur suddenly as a result of a blood clot severely restricting blood flow (acute mesenteric ischemia). Lack of oxygen-rich blood can permanently damage your intestines. You may experience sudden abdominal pain and, less often, bloody stools. This situation requires immediate medical care.

Chronic mesenteric ischemia occurs gradually as the main visceral arteries narrow. You may develop pain after eating, lose weight or develop a fear of eating caused by fear of stomach pain.

Mesenteric Ischemia can be considered as an attack on your gut (stomach and intestines) similar to a heart attack.

It is a disease with blood clot (thrombus) formation and severe narrowing in arteries of stomach and intestines leading to a sudden reduction in gut blood circulation and death of the stomach/intestinal cells.

In India, mesenteric ischemia patients are at least a decade younger than those in the western countries, with overall higher complications & death rate.

IS IT A SERIOUS PROBLEM?

Yes. It is an emergency condition and you must see a qualified vascular surgeon immediately.

WHY DOES IT HAPPEN?

Mainly two reasons:

  1. Clot, pushed out of the heart towards arteries of gut (seen in patients with pre-existing heart problems)
  2. Fresh clot formation at areas of partial blockage (in pre-existing diseased patients)

THE RISK FACTORS

  • Age >50 years
  • Smoking or tobacco chewing (Any age group)
  • Diabetes Mellitus
  • High blood pressure
  • High blood cholesterol levels/Obesity
  • Pre-existing heart disease/valvular heart disease
  • Those with blood clotting tendencies

WHAT ARE THE SYMPTOMS?

  • Severe abdominal pain (often abdominal sonography is normal)
  • Pain worsening after consuming food
  • Food fear and weight loss

 

Treatment

Surgery

Once it is determined that your stomach pain is caused by blocked intestinal arteries, you may need surgery. Dr. Srujal Shah performs conventional and minimally invasive procedures to improve blood flow to your intestines. Surgical options include:

Angioplasty

Angioplasty is a minimally invasive procedure that opens narrowed arteries. During an angioplasty, your surgeon inserts a long, flexible tube (catheter) that has a balloon on its tip. The surgeon usually places a small wire tube (stent) in your artery to keep it open. If you have a blood clot, your doctor may remove it during your angiogram.

Mesenteric artery bypass

A bypass creates an alternate route for blood to flow around the narrowed or blocked artery. Your surgeon sews a substitute blood vessel (graft) to a main artery to restore blood flow.

 
 
 

Mesenteric endarterectomy

In an endarterectomy, your doctor makes an incision in the large blood vessel that branches off your heart (aorta) to reach the mesenteric arteries and remove fat and cholesterol buildup (plaques) or the blood clot blocking the artery.

We treat people who are at high risk for complications during open surgery, such as older people, using minimally invasive surgery.