By Mayo Clinic Staff
Mesenteric ischemia (mez-un-TER-ik is-KEE-me-uh) is a condition caused by poor blood supply to your intestines. Mesenteric ischemia usually affects the small intestine, colon or both. It may also involve other organs in the digestive system. Mesenteric ischemia may be acute or chronic.
Acute mesenteric ischemia occurs suddenly as a result of blockage to the flow of oxygen-rich blood and 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 from narrowing in one or more of the arteries supplying blood to your intestines (visceral arteries). You may develop pain 1 to 2 hours after eating, This pain may make it hard for you to eat, leading to weight loss. You may also notice changes in the frequency of your bowel movements, as well as bloating, nausea and vomiting.
- Multidisciplinary approach. Mayo Clinic brings together the expertise of doctors who treat blood and lymph vessel disorders (vascular surgeons and vascular medicine specialists), 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 treatment tailored to your unique needs.
- Diagnostic expertise. Mesenteric ischemia can be mistaken for other disorders. Mayo Clinic has doctors who specialize in diagnosing and imaging the blood vessel system to find the cause of your problem.
- Experience. Doctors at Mayo Clinic treat more than 800 cases of mesenteric ischemia each year. Mayo Clinic doctors have experience with a range of treatments for mesenteric ischemia, including noninvasive procedures and surgery for people with complex conditions.
- Treatment options. Doctors at Mayo Clinic diagnose and treat mesenteric ischemia using several types of procedures, including a minimally invasive approach and open surgery.
Mayo Clinic in Rochester, Minn., ranks No. 1 for digestive disorders in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals for digestive disorders by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for digestive disorders.
Diagnosis of mesenteric ischemia begins with a description of your current symptoms, a medical history, physical exam 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) may perform tests to rule out other conditions and evaluate blood flow, including:
- Doppler ultrasound. High-frequency sound waves help your doctor see images of your blood vessels.
- CT scan/CT angiography. A CT scan uses X-rays to create detailed images of your arteries and of some organs. A CT angiogram (CTA) is a noninvasive way for doctors to see the details of your blood vessels, including narrowing and blockages.
- Magnetic resonance angiography (MRA). Magnetic fields and radio waves produce detailed images of your blood vessels.
- Mesenteric angiogram. A mesenteric angiogram is the standard test for evaluating blood flow and finding the blockage in the blood vessel. 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.
At Mayo Clinic, you and your doctor discuss treatment options for 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 switching to a healthy diet, exercising and stopping smoking are important parts of treatment.
Acute mesenteric ischemia is a medical emergency and requires immediate treatment.
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).
Interventional procedures and 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. Options include:
Angioplasty (with or without stenting). Angioplasty is a minimally invasive procedure that opens narrowed arteries. This procedure is also called endovascular revascularization. During an angioplasty, your doctor inserts a long, flexible tube (catheter) that has a balloon on its tip and when inflated will open the narrowed blood vessel.
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.
Specialists at Mayo Clinic generally recommend treatment for everyone with chronic mesenteric ischemia. Specific treatment depends on the extent of the blood vessel blockage and your overall health. Mayo Clinic's doctors' experience with mesenteric ischemia helps them tailor treatment to your condition.
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.
- U.S. Patients
- International Patients
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.
- U.S. Patients
- International Patients
The Gonda Vascular Center at Mayo Clinic in Rochester, 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.
- U.S. Patients
- International Patients
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.
See a list of publications from Mayo Clinic doctors on mesenteric ischemia on PubMed, a service of the National Library of Medicine.
May 09, 2015
- Cudnick MT, et al. The diagnosis of acute mesenteric ischemia: A systematic review and meta-analysis. Academic Emergency Medicine. 2013;20:1088.
- Hall JB, et al. Mesenteric ischemia. In: Principles of Critical Care. 3rd ed. New York, NY: McGraw-Hill; 2005. http://accessmedicine.com. Accessed Feb. 28, 2015.
- Pecoraro F, et al. Chronic mesenteric ischemia: Critical review and guidelines for management. Annals of Vascular Surgery. 2013;27:113.
- Oderich GS, et al. Mesenteric artery complications during angioplasty and stent placement for atherosclerotic chronic mesenteric ischemia. Journal of Vascular Surgery. 2012;55:1063.
- Greenberger NJ, et al. Mesenteric vascular disease. In: Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy. 2nd ed. New York, NY: McGraw-Hill; 2012. http://www.accessmedicine.com. Accessed Feb. 28, 2015.
- Golden, AK. Decision Support System. Mayo Clinic, Rochester, Minn. Feb. 18, 2015.
- Tallarita T, et al. Patient survival after open and endovascular mesenteric revascularization for chronic mesenteric ischemia. Journal of Vascular Surgery. 2013;57:747.
- Kanamori KS. Outcomes of reoperative open or endovascular interventions to treat patients with failing open mesenteric reconstructions for mesenteric ischemia. Journal of Vascular Surgery. 2014;60:1612.
- Ryer EJ, et al. Revascularization for acute mesenteric ischemia. Journal of Vascular Surgery. 2012;55:1682.
- Rajan E (expert opinion). Mayo Clinic, Rochester, Minn. April 28, 2015.