Descripción general

La isquemia mesentérica ocurre cuando los vasos sanguíneos (arterias) estrechados o bloqueados restringen el paso de la sangre que fluye al intestino delgado. Un flujo de sangre disminuido puede dañar permanentemente el intestino delgado. La pérdida repentina del flujo sanguíneo al intestino delgado (isquemia mesentérica aguda) a causa de un coágulo de sangre requiere cirugía de inmediato.

La isquemia mesentérica que se desarrolla a lo largo del tiempo (crónica) se trata con una angioplastia o una cirugía abierta. Si no se trata, la isquemia mesentérica crónica puede volverse aguda o puede ocasionar una gran pérdida de peso y desnutrición.

Mesenteric ischemia care at Mayo Clinic

Síntomas

Acute mesenteric ischemia

Signs and symptoms of the acute form of mesenteric ischemia include:

  • Abrupt, severe abdominal pain
  • Urgent need to have a bowel movement
  • Fever
  • Nausea and vomiting

Chronic mesenteric ischemia

Signs and symptoms of the chronic form of mesenteric ischemia include:

  • Abdominal pain that starts about 30 minutes after eating
  • Pain that worsens over an hour
  • Pain that goes away within one to three hours

When to see a doctor

If you have severe, abrupt abdominal pain that persists, seek emergency medical care. If you develop pain after eating, make an appointment with your doctor.

Causas

Both acute and chronic mesenteric ischemia are caused by a decrease in blood flow to the small intestine. Acute mesenteric ischemia is most commonly caused by a blood clot in the main mesenteric artery. The blood clot often originates in the heart. The chronic form is most commonly caused by a buildup of plaque that narrows the arteries.

Complicaciones

If not treated promptly, acute mesenteric ischemia can lead to:

  • Sepsis. This potentially life-threatening condition is caused by the body releasing chemicals into the bloodstream to fight infection. In sepsis, the body overreacts to the chemicals, triggering changes that can lead to multiple organ failure.
  • Irreversible bowel damage. Insufficient blood flow to the bowel can cause parts of the bowel to die.
  • Death. Both of the above complications can lead to death.

People with chronic mesenteric ischemia can develop:

  • Fear of eating. This occurs because of the after-meal pain associated with the condition.
  • Unintentional weight loss. This can occur as a result of the fear of eating.
  • Acute-on-chronic mesenteric ischemia. Symptoms of chronic mesenteric ischemia can progress, leading to the acute form of the condition.

Isquemia mesentérica - atención en Mayo Clinic

Dec. 20, 2018
References
  1. AskMayoExpert. Mesenteric arterial ischemia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
  2. Blauw JTM, et al. Mesenteric vascular treatment 2016: From open surgical repair to endovascular revascularization. Best Practice & Research Clinical Gastroenterology. 2017;31:75.
  3. Clair DG, et al. Mesenteric ischemia. New England Journal of Medicine. 2016;374:959.
  4. Kolkman JJ, et al. Diagnosis and treatment of chronic mesenteric ischemia: An update. Best Practice & Research Clinical Gastroenterology. 2017;31:49.>
  5. Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Jan. 23, 2018.

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