Small intestinal ischemia and infarction
Intestinal ischemia and infarction occurs when there is a narrowing or blockage of 1 or more of the arteries that supply the small intestine.
Intestinal necrosis; Ischemic bowel - small intestine; Dead bowel - small intestine; Dead gut - small intestine; Infarcted bowel - small intestine; Atherosclerosis - small intestine; Hardening of the arteries - small intestine
There are several possible causes of intestinal ischemia and infarction.
The main symptom of intestinal ischemia is abdominal pain. Other symptoms include:
Exams and Tests
Laboratory tests may show a high white blood cell (WBC) count (a marker of infection). There may be bleeding in the GI tract.
Some tests to detect the extent of damage include:
These tests do not always diagnose the problem. Sometimes, the only sure way to diagnose intestinal ischemia is with a surgical procedure.
In most cases, the condition needs to be treated with surgery. The section of intestine that has died is removed, and the healthy remaining ends of the bowel are reconnected.
Damage or death of the bowel tissue is a serious condition that can result in death if not treated right away. The outlook depends on the cause. Prompt treatment can lead to a good outcome.
Damage or death of the bowel tissue may require a colostomy or ileostomy. This may be short-term or permanent. Peritonitis is common in these cases. People who have a large amount of tissue death in the intestine can have problems absorbing nutrients. They can become dependent on getting nutrition through their veins.
Some people may become severely ill with fever and a bloodstream infection (sepsis).
When to Contact a Medical Professional
Call your health care provider if you have any severe abdominal pain.
Preventive measures include:
Cheng CC, Choi L, Cheema Z, Silva MB. Acute mesenteric ischemia. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 11th ed. Philadelphia, PA: Elsevier Saunders; 2014:939-946.
Hauser SC. Vascular diseases of the gastrointestinal tract. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 143.
Roline CE, Reardon RF. Disorders of the small intestine. In: Marx JA, Hockberger RS, Walls RM eds. Rosen's Emergency Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 92.
Review Date: 1/28/2016
Reviewed By: Subodh K. Lal, MD, gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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