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Mesenteric ischemia is ischemnia of the small intestine.
Signs and symptoms
Symptoms of ischemic colitis vary depending on the severity of the ischemia. The most common early signs of ischemic colitis include abdominal pain (often left-sided), with mild to moderate amounts of rectal bleeding. The sensitivity of findings among 73 patients were:
- abdominal pain (78%)
- lower digestive bleeding (62%)
- diarrhea (38%)
- Fever higher than 38°C (34%) (38°C equals approximately 100.4°F)
- abdominal pain (77%)
- abdominal tenderness (21%)
- The white blood cell count was more than 15,000/mm3 in 20 patients (27%)
- The serum bicarbonate level was less than 24 mmol/L in 26 patients (36%)
A systematic review concluded that D-dimer is not helpful, but newer serologic tests such as D-lactate, glutathione S-transferase (GST), intestinal fatty-acid binding protein (i-FABP) may be helpful.
There are devices which test the sufficiency of oxygen delivery to the colon. The first device approved by the U.S. FDA in 2004 uses visible light spectroscopy to analyze capillary oxygen levels. Use during Aortic Aneurysm repair detected when colon oxygen levels fell below sustainable levels, allowing real-time repair. In several studies, Specificity has been 90% or higher for acute colonic ischemia, and 83% for chronic mesenteric ischemia, with a sensitivity of 71%-92%. This device must be placed using endoscopy, however.,,
20% of patients will need surgery.
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