ABSTRACT
Pathophysiology and Clinical Presentation An embolus to the superior mesenteric artery is the most frequent (50%) cause
of acute mesenteric ischemia. This sudden occlusion of a relatively normal superior mesenteric artery, usually originating in the heart, produces severe constant abdominal pain, vomiting and diarrhea as the bowel constricts with progressive ischemia. A leukocytosis then ensues. The triad of severe pain out of proportion to tenderness, elevated white blood cell count and both nausea and diarrhea should lead to the diagnosis embolic ischemia. Conditions associated with mesenteric emboli are long standing atrial fibrillation, recent myocardial infarction and a history of other sys temic arterial embolic events.
