Arterial Distribution:
Celiac artery - foregut, hepatobiliary system, and spleen.
Superior mesenteric artery - small intestine and proximal mid colon.
Inferior mesenteric artery - distal colon and rectum.

Symptoms: abdominal pain, diarrhea, vomiting, gastrointestinal bleed.

Sources of emboli: mural thrombi after myocardial infarction, atrial thrombi after atrial fibrillation or mitral stenosis, vegetative endocarditis.

Laboratories: lactate level, amylase.

Imaging : edematous bowel wall, portal vein gas, pneumatosis intestinalis. Consider CT angiogram and magnetic resonance angiogram.

Medications depend on the underlying problem. Papaverine - arterial occlusive acute mesenteric ischemia or nonocclusive mesenteric ischemia. Heparin - mesenteric venous thrombosis. Warfarin - atrial fibrillation or mesenteric venous thrombosis. Broad spectrum antibiotics and pain medications for all patients. Thrombolytics - embolic acute mesenteric ischemia.

Please consider an official gastroenterology consult and refer to the sources below.

Sources:
1. Mesenteric ischemia

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