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Acute mesenteric ischaemia (gut stroke)

Ischaemia mesenterica acuta · Akutní mezenteriální ischemie (mrtvice střeva)

What it is

Sudden loss of blood flow to the bowel — a clot from the heart (atrial fibrillation), a clot on a narrowed artery, a venous clot or low flow in shock; the bowel dies within hours, and half or more die even with treatment.

Symptoms & signs

  • Severe belly pain far worse than the examination suggests
  • vomiting, urge to empty the bowel
  • blood in the stool later
  • shock, rigid belly when the bowel dies
  • chronic form: pain 30 minutes after meals, fear of eating, weight loss

🚩 Get help if…

  • call 112 / 911 now Sudden severe belly pain far worse than it looks
  • call 112 / 911 now Belly pain with blood in stool or vomiting
  • call 112 / 911 now Belly pain with a racing heart, fever or collapse
  • see a doctor soon Belly pain after meals with weight loss

Where it strikes

Medical treatment

  • CT angiography at once
  • fluids, heparin, antibiotics
  • Restore flow — endovascular stent or clot removal, or open surgery — and remove dead bowel trials support
  • second-look operation after 1–2 days
  • anticoagulation for AF and venous clots

Natural & lifestyle

  • Treat atrial fibrillation with anticoagulation
  • stop smoking
  • control blood pressure and cholesterol

Emerging & experimental

  • Hybrid theatres doing stent and bowel check together
  • blood markers for early diagnosis (D-lactate, I-FABP)

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Any delay for home remedies — bowel dies within hours not confirmed in trials
  • Small low-fat meals in the chronic form — eases pain after eating until repair anecdotal / traditional

ICD codes