Non-occlusive mesenteric ischemia
Citation, DOI, disclosures and article data
At the time the article was created Henry Knipe had no recorded disclosures.View Henry Knipe's current disclosures
At the time the article was last revised Henry Knipe had no recorded disclosures.View Henry Knipe's current disclosures
Non-occlusive mesenteric ischemia is the second most common cause of acute mesenteric ischemia, with a higher incidence in hospitalized and critical care patients.
Non-occlusive mesenteric ischemia accounts for ~25% (range 20-30%) of acute mesenteric ischemia. It most commonly affects patients >50 years 3.
Non-occlusive mesenteric ischemia occurs without arterial or venous occlusion in the region of bowel ischemia/infarction 1.
Systemic hypoperfusion from numerous causes 2,3:
- cardiac disease (e.g. myocardial infarction)
- systemic hypotension (e.g. cardiogenic, septic, or hemorrhagic shock) resulting in shock bowel
- blunt abdominal trauma
- hypotension following dialysis
- cardiac or major abdominal surgery
Medication-induced mesenteric vasospasm (e.g. vasoconstriction from digitalis, amphetamines, cocaine, vasopressin) can also be a cause 2.
Features of CT hypoperfusion complex may also be present and evaluation of extra-intestinal viscera is important 2.
- 1. Woodhams R, Nishimaki H, Fujii K, Kakita S, Hayakawa K. Usefulness of multidetector-row CT (MDCT) for the diagnosis of non-occlusive mesenteric ischemia (NOMI): assessment of morphology and diameter of the superior mesenteric artery (SMA) on multi-planar reconstructed (MPR) images. (2010) European journal of radiology. 76 (1): 96-102. doi:10.1016/j.ejrad.2009.05.012 - Pubmed
- 2. Laura A. Fitzpatrick, Michael D. Rivers-Bowerman, Seng Thipphavong, Sharon E. Clarke, Judy A. Rowe, Andreu F. Costa. Pearls, Pitfalls, and Conditions that Mimic Mesenteric Ischemia at CT. (2020) RadioGraphics. 40 (2): 545-561. doi:10.1148/rg.2020190122 - Pubmed
- 3. Markus Trompeter, Thurid Brazda, Christopher T. Remy, Thomas Vestring, Peter Reimer. Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy. (2002) European Radiology. 12 (5): 1179. doi:10.1007/s00330-001-1220-2 - Pubmed
- 4. Pérez-García C, de Miguel Campos E, Fernández Gonzalo A, Malfaz C, Martín Pinacho JJ, Fernández Álvarez C, Herranz Pérez R. Non-occlusive mesenteric ischaemia: CT findings, clinical outcomes and assessment of the diameter of the superior mesenteric artery. (2018) The British journal of radiology. 91 (1081): 20170492. doi:10.1259/bjr.20170492 - Pubmed