Focal ischaemia of the bowel - Vascular disease of the bowel

Focal ischaemia of the bowel

Definition

Localised bowel pathology may result in focal area of ischaemia.

Aetiology

Underlying causes include strangulation of a hernia, intussusception, or a volvulus in which a loop of bowel twists on itself usually around a fibrous peritoneal band or adhesion.

Pathophysiology

The ischaemia results from venous infarction due to strangulation. The thin draining veins are occluded by external pressure resulting in venous congestion and hence a failure of arterial supply to the segment of bowel.

Clinical features/management

The underlying cause requires identification and treatment. If blood flow is not restored, a progression to infarction and necrosis necessitates bowel resection.