Definition

- Ischaemic necrosis of a segment of the small intestine.

Epidemiology

- Usually seen in patients aged >50 y.

Aetiology

- Thrombosis overlying an unstable atherosclerotic plaque in the superior mesenteric artery.

- Thromboemboli from the left ventricle or left atrium.

- Hypovolaemia.

Pathogenesis

- Sudden reduction in blood flow through the superior mesenteric artery leads to ischaemic necrosis of a segment of the small bowel.

- Massive haemorrhage into the infarcted bowel causes hypovolaemia.

- Bacteria rapidly permeate the devitalized intestinal wall, leading to sepsis.

Presentation

- Acute onset of severe abdominal pain with bloody diarrhoea and hypovolaemia.

Macroscopy

- The infarcted small bowel appears dusky purple (Fig. 7.3).

- On opening the segment of bowel, large amounts of blood are present in the lumen and the mucosal surface is friable and necrotic.

Histopathology

• Full-thickness necrosis of the bowel wall. Milder changes include crypt atrophy (withering).

Prognosis

- Early laparotomy is essential to resect the infarcted segment of bowel.

-Survival is generally poor due to the rapid development of hypovolaemia and sepsis, causing multiorgan failure.

مواضيع ذات صلة

وسائط الالتهاب الحاد

قرحة الاثني عشري Duodenal Ulcer

أمراض الخلية

الالتهاب الرئوي الفصي (ذات الرئة الفصية) (Lobar Pneumonia)

النوبة القلبية ( Heart attack )

التهاب القصبات الهوائية ( Bronchitis )

قرحة المعدة ( Peptic ulcer)

الامراض المشتركة Zoonosis

Zellweger Syndrome

XP) Xeroderma Pigmentosum)

Xanthoma

WAGR Syndrome