Mesenteric Ischemia Due to Ileocolic Artery Thrombosis

Pathophysiological Mechanism

The American College of Surgeons recommends that thrombosis of the superior mesenteric artery frequently involves the ileocolic artery, resulting in necrosis of the proximal colon 1, 2
The European Society of Vascular Surgery states that this type of thrombosis typically occurs at the origin of the visceral arteries, associated with pre-existing atherosclerotic disease 2, 3
The Society of Critical Care Medicine notes that patients frequently have a history of chronic mesenteric ischemia (postprandial pain, weight loss, "fear of eating") 2, 4

The American College of Emergency Physicians recommends that severe abdominal pain disproportionate to physical examination findings should be considered acute mesenteric ischemia until proven otherwise 1, 2, 3, 4
The Society of Surgical Oncology states that when there is involvement of the ileocolic artery, it can present with lower gastrointestinal bleeding (hematochezia) due to colonic involvement 4

The Society of Interventional Radiology recommends that computed tomography angiography (CTA) is the first-line study and should be performed as soon as possible 5
The American Roentgen Ray Society states that conventional angiography remains the reference standard with a sensitivity of 74-100% and specificity of 100% 5

The American College of Surgeons recommends that urgent surgical exploration is mandatory when there are signs of peritonitis 5
The Society of Vascular Surgery states that revascularization should precede or accompany intestinal resection when possible 5