Regarding blood supply to the abdominal viscera:
a) List the abdominal structures supplied by the coeliac axis, superior mesenteric artery (SMA) and inferior mesenteric artery (IMA). (30% marks)
b) Explain which areas of intestine are more susceptible to mesenteric arterial ischaemia.
c) Compare and contrast the risk factors, clinical characteristics, treatment, and prognosis of mesenteric arterial ischaemia (occlusive and non-occlusive) and mesenteric venous thrombosis.
a) The structures supplied by each major branch are:
b) Areas of intestine which are more susceptible to mesenteric arterial ischaemia:
The clinical scenario is said to differentiate the causes of mesenteric ischaemia, as the clinical findings are typically similar for all of them:
And if you wait long enough, everything starts looking like severe septic shock and multiorgan system failure. In short, the abdomen is usually the same on examination, and the way you come to the conclusion that this must be embolic or venous, is by discovering that the patient is in AF, or has recently had a bowel resection for a colonic carcinoma, or something along those lines. Because of this, the risk factors and clinical characteristics were rolled together in this tabulated response.
|Type||Risk factors and
|Occlusive mesenteric ischaemia||
|Non-occlusive mesenteric ischaemia||
|Venous mesenteric ischaemia||
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