ABSTRACT

Mesenteric vascular disease encompasses a family of diseases of which the end result is injury to the small or large bowel resulting from diminished blood flow or inadequate oxygen and nutrient delivery. Mesenteric disease is present in 18% of patients older than 65 years of age and in 70% of those undergoing aortofemoral bypass (1). The diseases vary from anatomically definable and clinically reproducible symptom complexes, such as those seen in superior mesenteric artery embolism, to more erratic and unpredictable patterns, such as those of ischemic colitis. The estimated frequency of causes of acute mesenteric ischemia are arterial occlusion 50%, nonocclusive mesenteric ischemia 20% to 30%, venous occlusion 5% to 15%, as well as extravascular sources such as incarcerated hernia, volvulus, intussusception, and adhesive bands (2). Although it is important to view these diseases clinically as individual entities often requiring different clinical approaches, it is equally important to recognize the common anatomic and physiologic principles involved in each syndrome.