When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Enfermedad isquémica intestinal

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 15 Jul 2025
Last updated: 05 Jan 2024

Summary

Definition

History and exam

Key diagnostic factors

  • dolor abdominal
  • abdomen doloroso a la palpación
Full details

Other diagnostic factors

  • hematoquecia/melena
  • diarrea
  • pérdida de peso
  • soplo abdominal
  • vasculitis
  • aturdimiento, palidez, disnea
  • miedo a ingerir alimentos (sitofobia)
Full details

Risk factors

  • edad avanzada
  • antecedentes de tabaquismo
  • estados de hipercoagulabilidad
  • fibrilación auricular
  • infarto de miocardio
  • defectos estructurales del corazón
  • antecedentes de vasculitis
  • aterosclerosis
  • cirugía cardiovascular reciente
  • shock
  • insuficiencia cardíaca congestiva
  • síndrome del intestino irritable
  • carcinoma colónico
  • estreñimiento
  • uso de laxantes a largo plazo
  • uso de vasopresores, digitalina, cocaína
Full details

Diagnostic tests

1st tests to order

  • Angiografía por TC
  • hemograma completo (HC)
  • panel químico, incluida la PCR
  • panel de coagulación, tipo y criba, coincidencia cruzada
  • gasometría arterial/nivel de lactato
  • electrocardiograma (ECG)
  • radiografía de tórax (RT) en bipedestación
  • radiografías de abdomen
  • sigmoidoscopia o colonoscopia
  • endoscopia del tracto gastrointestinal superior
Full details

Tests to consider

  • angiografía por resonancia magnética
  • angiografía mesentérica
  • ultrasonido dúplex/doppler mesentérico
Full details

Emerging tests

  • espectroscopia abdominal en el infrarrojo cercano

Treatment algorithm

ACUTE

evidencia de infarto, perforación o peritonitis

sin evidencia de infarto, perforación o peritonitis

ONGOING

isquemia mesentérica crónica

isquemia colónica no aguda

Contributors

Authors

Monjur Ahmed, AGAF, FACG, FACP, FASGE, FRCP, MD, MRCP

Professor of Medicine

Thomas Jefferson University

Gastroenterologist

Thomas Jefferson University Hospital

Philadelphia

PA

Disclosures

MA declares that he has no competing interests.

Acknowledgements

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

Disclosures

AVR, JL, AB, JHM, and AF declare that they have no competing interests.

Peer reviewers

Eli D. Ehrenpreis, MD

Professor of Medicine

Rosalind Franklin University Medical School

Chicago

IL

Disclosures

EDE declares that he has no competing interests.

Andrew Poullis, BSc, MBBS, MD, FRCP

Consultant Gastroenterologist

St George’s Hospital

London

UK

Disclosures

AP declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Brandt LJ, Feuerstadt P, Longstreth GF, et al. ACG clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon ischemia (CI). Am J Gastroenterol. 2015 Jan;110(1):18-44.Full text  Abstract

Bala M, Catena F, Kashuk J, et al. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2022 Oct 19;17(1):54.Full text  Abstract

Björck M, Koelemay M, Acosta S, et al. Editor's choice - management of the diseases of mesenteric arteries and veins: clinical practice guidelines of the European Society of Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2017 Apr;53(4):460-510.Full text  Abstract

American College of Radiology. ACR appropriateness criteria: radiologic management of mesenteric ischemia. 2022 [internet publication].Full text

Tilsed JV, Casamassima A, Kurihara H, et al. ESTES guidelines: acute mesenteric ischaemia. Eur J Trauma Emerg Surg. 2016 Apr;42(2):253-70.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Enfermedad isquémica intestinal images

  • Differentials

    • Colitis infecciosa
    • Colitis ulcerosa
    • Enfermedad de Crohn
    More Differentials

  • Guidelines

    • Acute mesenteric ischemia: updated guidelines
    • ACR appropriateness criteria: radiologic management of mesenteric ischemia
    More Guidelines

  • Patient information

    Enfermedad isquémica intestinal: ¿qué es?

    More Patient information

  • Videos

    Demostración animada de como realizar un electrocardiograma (ECG)

    Demostración animada de venopunción y flebotomía

    More videos
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer