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Colonic Vascular Disorders -
Mesenteric perfusion
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Written by Dr Sebastian Zeki
MCQs for this page
Mesenteric perfusion
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Arteriolar smooth
muscle relaxtion
Decreased
perfusion
pressure
Mucosal ischaemia
Adenosine and other
metabolites of mucosal
ischaemia
Sympathetic nervous
system Renin-
angiotensin axis
Venoconstricion
Arteriolar smooth
muscle contriction
Venodilatation
Vasopressin (ADH)
Mesenteric perfusion (
10 to 35
% of cardiac output) -Physiol
-
ogy
Intestines can compensate for 75 % acute reduction in mesenteric
blood flow for up to 12 hours without substantial injury, in part
because of increased oxygen extraction
Collateral circulation opens immediately
Progressive vasoconstriction
develops in the obstructed bed,
increasing its pressure and thereby
reducing collateral flow.
Ischaemia may persist after restoration so
therapeutic infusion of papaverine (a
vasodilator) during angiography often
given
After several hours
Early ischaemic damage is due
to reperfusion injury -It is
initiated by an increased
release of oxygen free radicals,
other toxic byproducts of
ischemic injury, and neutrophil
activation
Hypoxia is main mechanism if
longer ischaemic time
Written by Dr Sebastian Zeki
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