Sudden decrease in the blood supply to the bowel, resulting in bowel ischaemia and, if not promptly treated, death

Aetiology

• Most commonly caused by an embolus/thrombosis (usually embolus from AF) sticking in a narrowed (from atherosclerosis) super mesenteric artery
• Chronic - cramps, like angina of the guts
• Acute - small bowel gets infarcted, colon lives (due to marginal artery)

Clinical features

• Generalised abdominal pain out of proportion to clinical findings
• Nausea and vomiting

Investigations

• Bloods: ↑ lactate, CRP may be normal, WCC may be slightly ↑
• CT angiography: gold standard, shows arterial blockage due to emboli or thrombus

Management

• Surgery
  • If bowel non-viable - resection
  • If bowel viable - SMA embolectomy