Mesenteric ischemia occurs when atherosclerosis, or hardening of the arteries, happens in the blood vessels which lead to the intestines. Mesenteric ischemia generally occurs in patients who already have fairly extensive peripheral vascular disease and atherosclerosis. These patients almost always have a history of smoking, and often have had problems with atherosclerosis in the past (heart attacks, claudication, etc).
Because there is narrowing of the blood vessels leading to the intestines, people with mesenteric ischemia often have severe abdominal pain after eating. This is because after eating, the intestine requires more blood to digest food, and the narrowed arteries cannot supply the blood needed to the intestines, resulting in pain. Because of the pain, these patients often start eating less, and can come to the attention of a physician after a considerable weight loss.
Mesenteric ischemia can be diagnosed in a few different ways, but is most commonly diagnosed with either an ultrasound or a CT scan. Just like with other vascular beds, the ultrasound can diagnose narrowings in the blood vessels leading to the intestines by measuring the flow patterns and velocities of the blood. CT scans, on the other hand, are useful because they show a direct picture of the narrowed blood vessels.
Mesenteric artery stenosis and mesenteric ischemia is most often treated with endovascular stenting. This is a minimally invasive technique which usually involves a small puncture in an artery in the arm or groin. The surgeon then is able to carefully direct a stent into the precise area where the artery narrows. The stent is expanded using a balloon. The balloon is then withdrawn, leaving the stent in place. In this way, blood is able to flow easily into the arteries of the intestines, and the patient often experiences dramatic relief of their symptoms.