ABSTRACT
Mesenteric ischaemia encompasses a wide spectrum of disorders, with the common end point being lack of adequate blood/oxygen delivery to a portion of the intestine. This chapter explores the different aetiologies, diagnostic modalities and management of acute mesenteric ischaemia. The blood supply to the gastrointestinal tract arises primarily from three main branches of the abdominal aorta: the coeliac artery, the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA). The SMA primarily supplies the midgut, from the duodenum to the splenic flexure of the colon. The IMA primarily supplies the hindgut, from the splenic flexure of the colon to the upper rectum. Patients with mesenteric venous thrombosis often have a less acute presentation as compared with arterial embolism or thrombosis. The radiographic diagnosis of Non-occlusive mesenteric ischaemia (NOMI) has traditionally been made with conventional angiography. The key to management of NOMI is reversing the underlying inciting factors to allow for rapid restoration of intestinal blood flow.
