Instestinal angina
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This document discusses the case of a 73-year-old male admitted to the hospital following a fall at home who experienced a decline in condition. Imaging showed right and left pleural effusions, abnormalities in the right colon, and signs of mesenteric ischemia. The patient refused further treatment and died. The document then provides information on acute mesenteric ischemia, including causes, risk factors, mortality rates, diagnosis challenges, and imaging findings.
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Instestinal angina
- 5. Clinical Profile of Acute Mesenteric Ischemia Cause Incidence Age Prior Symptoms Risk Factors Mortarlity Thrombosis 50% Elderly Instestinal Angina +/- Sytemic Atherosclerosis Very High Embolic 25% Elderly No Recent MI,CHF Arrhythnias Rheumatic fever High NOMI 20% Elderly No Cardiogenic shock Bypass, Pressors, Sepsis, Burns, Pancreatitis Highest Mesenteric Venous Thrombosis 5% Young Asymptomatic Thrombosis indolent+/- Hypercoagulability Portal Hypertension Trauma, Inflammation Prior surgery Lowest
- 7. Plain Abdomen X ray Radiographic evidence. The arrow indicates "thumbprinting" of the transverse colon. Note the accentuated focal thickening that indents the air of the bowel as if a thumb were pressing on the air column. This finding is not specific to ischemic disease; it also is reported in inflammatory conditions such as Clostridium difficile colitis and infiltrating neoplasms such as lymphoma.
- 8. Plain Abdomen X ray cntd Pneumotosis intestinalis= bowel wallnecrosis Air in Portal system – late sign