Small bowel ischemia

Last revised by Michael P Hartung on 4 Feb 2022

Citation, DOI, disclosures and article data

Citation:

Gaillard F, Hartung M, Bell D, et al. Small bowel ischemia. Reference article, Radiopaedia.org (Accessed on 08 Jun 2024) https://doi.org/10.53347/rID-19015

DOI:

https://doi.org/10.53347/rID-19015

Permalink:

https://radiopaedia.org/articles/19015?iframe=true

rID:

19015

Article created:

1 Aug 2012, Frank Gaillard ◉ ◈

Disclosures:

At the time the article was created Frank Gaillard had no recorded disclosures.

View Frank Gaillard's current disclosures

Last revised:

4 Feb 2022, Michael P Hartung ◉

Disclosures:

At the time the article was last revised Michael P Hartung had no recorded disclosures.

View Michael P Hartung's current disclosures

Revisions:

26 times, by 9 contributors - see full revision history and disclosures

Systems:

Gastrointestinal

Tags:

refs, cases, rg_38_5_edit, rg_40_2_edit

Synonyms:

Small bowel ischemia

Small bowel ischemia may be a life-threatening condition, arising from any one of numerous causes of disturbance of the normal blood flow through the small bowel wall.

Pathology

Etiology

It can be divided into acute and chronic forms, with the main underlying etiologies (each discussed separately) being:

acute
- occlusive mesenteric ischemia
  - superior mesenteric artery occlusion (two-thirds of cases)
  - superior mesenteric vein occlusion (5-10% of cases)
- non-occlusive mesenteric ischemia (e.g. shock bowel) ²
  - systemic hypotension (e.g. cardiogenic, septic, or hemorrhagic shock)
  - blunt abdominal trauma
  - medication-induced (e.g. vasoconstriction from digitalis, amphetamines, cocaine)
- small vessel involvement
  - chemotherapy-induced enteropathy (possibly ischemic in nature)
  - acute radiation enteritis
  - vasculitides (rare)
- small bowel obstruction
  - increasing bowel wall diameter increases bowel wall tension, which increases the resistance to incoming blood flow
chronic
- atherosclerotic stenosis of the superior mesenteric artery (e.g. mesenteric angina)
- chronic radiation enteritis

Quiz questions

References

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