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Gastroenterologist

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Ischemic bowel disease: causes and pathogenesis

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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The main causes of ischemic bowel disease are:

Atherosclerosis, localized in the mouths of the corresponding arteries (the most common cause);
systemic vasculitis (nonspecific aortoarteriog, obliterating thrombangiitis of Burger, nodular panarteritis, etc.);
systemic connective tissue diseases;
fibro-muscular dysplasia;
abnormalities of vascular development (hypoplasia);
compression of vessels from the outside (swelling, adhesive process, enlarged lymph nodes);
infective endocarditis;
sepsis;
hereditary hemolytic (microspherocytic) anemia;
polycythemia, etc.

Infringement of blood supply of various parts of the intestine leads to pronounced dystrophic, ischemic (varying degrees of severity) changes in the intestinal wall and (as the highest degree of ischemia) necrosis of the intestine.

Classification of ischemic bowel disease

Boleu et al. (1978) suggest the following classification of disturbances of mesenteric circulation:

Acute mesenteric ischemia.
1. Non-occlusive mesenteric ischemia.
2. Embolism of the upper mesenteric artery.
3. Thrombosis of the upper mesenteric artery.
4. Local segmental ischemia.
Chronic mesenteric ischemia ("abdominal angina")
Colon's ischemia:
1. reversible ischemic colopathy;
2. transient ulcerative ischemic colitis;
3. chronic ulcerative ischemic colitis;
4. stricture of large intestine;
5. gangrene of the colon.

trusted-source [1], [2], [3], [4], [5], [6]

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