Mesenteric ischemia (is-KE-me-uh) is a chronic condition caused by poor blood supply to your intestines. It results from narrowing in one or more of the arteries supplying blood to your intestines (visceral arteries). It also can occur suddenly as a result of a blood clot severely restricting blood flow (acute mesenteric ischemia). Lack of oxygen-rich blood can permanently damage your intestines. You may experience sudden abdominal pain and, less often, bloody stools. This situation requires immediate medical care.

Chronic mesenteric ischemia occurs gradually as the main visceral arteries narrow. You may develop pain after eating, lose weight or develop a fear of eating caused by fear of stomach pain.

Mayo Clinic brings together the expertise of doctors who treat blood and lymph vessel disorders (vascular surgeons), radiologists who perform medical procedures (interventional radiologists) and doctors who treat heart disease (cardiologists) to diagnose and treat mesenteric ischemia. This collaborative approach ensures that you receive a thorough evaluation and the treatment that's most appropriate for you. Doctors at Mayo Clinic diagnose and treat mesenteric ischemia using several types of surgery.

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Diagnosis of mesenteric ischemia begins with a physical exam, a medical and family history and blood tests. Your doctor will ask you questions about your symptoms. You may also need an evaluation by a gastroenterologist.

As part of the diagnosis, doctors who specialize in the interpretation of medical images (radiologists) will perform tests to rule out other conditions and evaluate blood flow, including:

  • Endoscopy. During an endoscopy, your doctor inserts a catheter with a tiny camera on the tip (endoscope) into your mouth and guides the endoscope through your upper digestive system. An endoscopy helps your doctor determine if conditions such as ulcers or inflammation cause your stomach pain.
  • Colonoscopy. Your doctor inserts a catheter with an endoscope into your rectum to view your colon.
  • Ultrasound. High-frequency sound waves help your doctor see images of your blood vessels. Ultrasound also can be used to evaluate your liver, gallbladder and pancreas.
  • CT scan. A CT scan uses X-rays to create detailed images of your arteries and of some organs.
  • Magnetic resonance angiography (MRA). Magnetic fields and radio waves produce detailed images of your blood vessels.
  • Angiogram. A mesenteric angiogram is the standard test for evaluating blood flow and finding the blockage. In this test, your doctor guides a thin, flexible tube (catheter) through the artery and inserts a dye to make the artery visible on an X-ray. Sometimes the doctor can treat the blocked arteries with a balloon angioplasty or stent during the angiogram.
  • X-ray. X-rays use radiation to create images of your internal organs. Your doctor may give you a barium solution to improve the images of your intestines.

Read more about endoscopy, colonoscopy, ultrasound, CT scan, and X-ray at MayoClinic.com.

At Mayo Clinic, you and your doctor discuss treatment options for chronic mesenteric ischemia. The most appropriate treatment depends on the severity of your symptoms, the cause and extent of your artery blockage and your other medical conditions. Lifestyle changes such as eating healthy, exercising and smoking cessation are important parts of treatment.

Acute mesenteric ischemia is a medical emergency and requires immediate surgery.

Medication

Mayo Clinic doctors may prescribe drugs to lower your blood pressure and cholesterol. Antibiotics may be needed if swelling (colonic ischemia) is found in the large intestine (colon) during a colonoscopy. If you have rapidly progressing (acute) mesenteric ischemia or blood clots in your intestinal veins (mesenteric venous thrombosis) you may need drugs to help prevent blood clots (anticoagulants).

Surgery

Once your doctor determines that your stomach pain is caused by blocked intestinal arteries, you may need surgery. Doctors at Mayo Clinic perform conventional and minimally invasive procedures to improve blood flow to your intestines. Surgical options include:

  • Angioplasty. Angioplasty is a minimally invasive procedure that opens narrowed arteries. During an angioplasty, your surgeon inserts a long, flexible tube (catheter) that has a balloon on its tip. The surgeon usually places a small wire tube (stent) in your artery to keep it open. If you have a blood clot, your doctor may remove it during your angiogram.
  • Mesenteric artery bypass. A bypass creates an alternate route for blood to flow around the narrowed or blocked artery. Your surgeon sews a substitute blood vessel (graft) to a main artery to restore blood flow.
  • Mesenteric endarterectomy. In an endarterectomy, your doctor makes an incision in the large blood vessel that branches off your heart (aorta) to reach the mesenteric arteries and remove fat and cholesterol buildup (plaques) or the blood clot blocking the artery.

Mayo Clinic doctors treat people who are at high risk for complications during open surgery, such as older people, using minimally invasive surgery.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Doctors trained in treating blood and lymph vessel disorders (vascular surgeons), radiologists who perform medical procedures (interventional radiologists), doctors who treat heart disease (cardiologists) and doctors who treat digestive diseases (gastroenterologists) diagnose and treat mesenteric ischemia.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Doctors who treat blood and lymph vessel disorders (vascular surgeons) work with radiologists who perform medical procedures (interventional radiologists), doctors who treat heart disease (cardiologists) and doctors who treat digestive diseases (gastroenterologists) to diagnose and treat mesenteric ischemia.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

The Gonda Vascular Center at Mayo Clinic in Minnesota brings together doctors who treat heart disease (cardiologists), doctors who treat blood and lymph vessel disorders (vascular and endovascular surgeons), doctors who treat digestive diseases (gastroenterologists) and radiologists who perform medical procedures (interventional radiologists) to diagnose and treat mesenteric ischemia.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic researchers are studying whether minimally invasive surgery such as angioplasty is as effective as open surgery for treating mesenteric ischemia, among other studies.

Mayo Clinic publications

See a list of publications from Mayo Clinic doctors on mesenteric ischemia on PubMed, a service of the National Library of Medicine

Dec. 03, 2012