Last reviewed: August 2019
Last updated: March  2019

Summary

Definition

History and exam

Other diagnostic factors

  • hematochezia/melena
  • diarrhea
  • abdominal tenderness
  • weight loss
  • abdominal bruit
  • vasculitis
  • light headedness, pallor, dyspnea
  • food fear (sitophobia)

Risk factors

  • old age
  • history of smoking
  • hypercoagulable states
  • atrial fibrillation
  • myocardial infarction
  • structural heart defects
  • history of vasculitis
  • recent cardiovascular surgery
  • shock
  • congestive heart failure
  • atherosclerosis
  •  previous ileostomy
  • irritable bowel syndrome
  • colonic carcinoma
  • constipation
  • long-term laxative use
  • use of vasopressors, digitalis, cocaine

Diagnostic investigations

1st investigations to order

  • CBC
  • chemistry panel including serum lactate
  • coagulation panel
  • arterial blood gas/lactate level
  • ECG
  • erect CXR
  • abdominal x-rays
  • CT scan with contrast/CT angiogram
  • sigmoidoscopy or colonoscopy
Full details

Investigations to consider

  • mesenteric angiography
  • mesenteric duplex ultrasound
  • magnetic resonance angiography
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Clinical Senior Lecturer

Honorary Consultant Colorectal Surgeon

Department of Surgery and Cancer

Imperial College London

London

UK 

Disclosures

AVR declares that he has no competing interests.

Clinical Research Fellow

Department of Surgery and Cancer

Imperial College London

London

UK 

Disclosures

JL declares that he has no competing interests.

Dr Alex von Roon and Dr James Lewis would like to gratefully acknowledge Dr Amir Bastawrous, Dr Jennifer Holder-Murray, and Dr Alessandro Fichera, the previous contributors to this topic.

Peer reviewers VIEW ALL

Professor of Medicine

Rosalind Franklin University Medical School

Chicago

IL

Disclosures

EDE declares that he has no competing interests.

Consultant Gastroenterologist

St George’s Hospital

London

UK

Disclosures

AP declares that he has no competing interests.

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