Vascular disorders of the intestine (ischemic colitis, mesenterial thrombosis)

1. Big picture

Vascular disorders of the intestine are ischemic emergencies caused by reduced arterial inflow, impaired venous drainage, or low-flow hypoperfusion. The key exam idea is:

Abdominal pain + vascular risk factors + disproportionate severity = think intestinal ischemia until proven otherwise.

The two most important clinical patterns are:

1. Ischemic colitis Usually older patient, transient low-flow ischemia of the colon → crampy left lower abdominal pain + bloody diarrhea.

2. Acute mesenteric ischemia / mesenteric thrombosis Sudden intestinal hypoperfusion, usually involving the superior mesenteric artery or vein → severe abdominal pain out of proportion to physical findings → bowel necrosis if missed.

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