Editing Mesenteric ischaemia (section)

=== '''Presentation''' ===

* Acute onset abdominal pain that is out of proportion with physical findings (tenderness to palpation does not develop until full-thickness ischaemia is present)
* May have spontaneous bowel evacuation
** This triad is most seen with SMA embolism ischaemia, but it only is found about a third of the time overall
* May have n/v/d
* 16% have PR bleeding
* Look for recent cardiac events/risk factors for embolisation
* Bowel necrosis presents with tachycardia, hypotension, fever, and systemic sepsis
* '''SMA embolism''' - generally quite abrupt, rapid decline, because no collaterals
** Survival decreases from 50% to 30% when the diagnosis is made >24 hours after symptom onset
* '''Thrombotic''' - insidious progression of symptoms - abdominal pain, distension, diarrhoea, acidosis, sepsis, GIT bleeding
* '''NOMI''' - very unpredictable presentation, often critically ill.