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Please help! What is the difference between Acute vs chronic Mesenteric ischemia vs ischemic colitis. Is it all the same on the usmle how will we differentiate the three??
Please help! What is the difference between Acute vs chronic Mesenteric ischemia vs ischemic colitis. Is it all the same on the usmle how will we differentiate the three??
Please help! What is the difference between Acute vs chronic Mesenteric ischemia vs ischemic colitis. Is it all the same on the usmle how will we differentiate the three??
acute ischemia is usually a sudden embolic event, caused by cholesterol embolism usually
i[I]schemic colitis is usually caused by hypoperfusion to the gut[/I] (e.g. during shock, etc) and is more likely in the SMA/IMA watershed area
I disagree and think you misunderstood the concept of ischemic colitis:
'Ischemic colitis (ischaemic colitis in British English) is a medical condition in which inflammation and injury of the large intestine result from inadequate blood supply. Although uncommon in the general population, ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia.'
Pls see http://en.wikipedia.org/wiki/Ischemic_colitis for more on ischemic colitis.
Acute arterial mesenteric ischemia has 3 causes:
1.embolic-> occlusion SMA, distal to middle colic artery-> spares proximal jejunum and transverse colon. Emboli originate in the left atrium or left ventricle
2. thrombotic-> at origin of SMA, cause by thrombosis on a superimposed area of atherosclerosis-> involes the entire area vasc. by SMA
3. nonocclusive- due to vasoconstriction of mesenteric vessels in low-flow states or admin. of vasopressors
Acute venous occlusion in hypercoagulable states- involves commonly SMV
Source: First Aid for the ABSITE 2012
Hmm... I just read that wikipedia page... please refer on that same page to "non-occlusive ischemia" and "pathophysiology". I don't see where I was wrong so I guess as long as it contributes to helping the OP differentiate between the various pathophysiologies...
I'll add that these questions showed up on my step 1 and my understanding of these concepts proved to be sufficient
Maybe I misunderstood what you were trying to say. I thought you were wrong when you said those 2 things I quoted in my previous reply because:
1. acute ischemia is not caused solely by embolism
2. ischemic colitis is due to mesenteric ischemia (SMA/IMA), which has the 4 causes I wrote in my previous post- not just vasoconstriction, which you said was the only cause of ischemic colitis.
So I had the feeling you mixed these 2 bolded concepts in your reply.
acute ischemia is usually a sudden embolic event, caused by cholesterol embolism usually
ischemic colitis is usually caused by hypoperfusion to the gut (e.g. during shock, etc) and is more likely in the SMA/IMA watershed area