Definition
- Inadequate perfusion of mesenteric microvasculature in the setting of no vascular disease
Aetiology
- Develops in setting of severe systemic illness
- In association with cardiorespiratory shock and multi-organ failure
- Exacerbated by inotropic agents and vasopressors
Diagnosis:
- High clinical suspicion
- Angiography: Arterial vasoconstriction with no obstruction point
- Exploratory laparotomy with pulsatile flow in large vessels
Management
- Optimise cardiac output
- Treat any underlying sepsis
- Remove inotropic/vasoconstrictive agents
- +/- Papaverine 30-60mghr intramesenteric arterial infusion
- Glucagon 2-4mg/hr will increase splanchnic flow
Prognosis