Ischemic bowel disease - Causes and pathogenesis

The main causes of ischemic bowel disease are:

• atherosclerosis localized in the mouths of the corresponding arteries (the most common cause);
• systemic vasculitis (nonspecific aortoarteriitis, Buerger's thromboangiitis obliterans, nodular panarteritis, etc.);
• systemic connective tissue diseases;
• fibromuscular dysplasia;
• vascular developmental anomalies (hypoplasia);
• compression of blood vessels from the outside (tumor, adhesions, enlarged lymph nodes);
• infective endocarditis;
• sepsis;
• hereditary hemolytic (microspherocytic) anemia;
• polycythemia, etc.

Disruption of the blood supply to various parts of the intestine leads to pronounced dystrophic, ischemic (of varying degrees of severity) changes in the intestinal wall and (as the highest degree of ischemia) intestinal necrosis.

Classification of ischemic bowel disease

Boleу et al. (1978) propose the following classification of mesenteric circulation disorders:

1. Acute mesenteric ischemia.
   1. Non-occlusive mesenteric ischemia.
   2. Superior mesenteric artery embolism.
   3. Thrombosis of the superior mesenteric artery.
   4. Local segmental ischemia.
2. Chronic mesenteric ischemia ("abdominal angina")
3. Colonic ischemia:
   1. reversible ischemic colopathy;
   2. transient ulcerative ischemic colitis;
   3. chronic ulcerative ischemic colitis;
   4. colon stricture;
   5. gangrene of the colon.

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