Mesenteric Ischemia (8 of 12)

Symptoms and Signs

The early hallmark of mesenteric ischemia is severe pain
but minimal physical findings. The abdomen remains soft,
with little or no tenderness. Mild tachycardia may be
present. Later, as necrosis develops, signs of peritonitis
appear, with marked abdominal tenderness, guarding,
rigidity, and no bowel sounds. The stool may be
heme-positive (increasingly likely as ischemia progresses).
The usual signs of shock develop and are frequently
followed by death.

Sudden onset of pain suggests but is not diagnostic of an
arterial embolism, whereas a more gradual onset is typical
of venous thrombosis. Patients with a history of
postprandial abdominal discomfort (which suggests
intestinal angina) may have arterial thrombosis