Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be going through

mesenteric ischemia. And as always, you can find written notes on this topic at zero definals.com

slash mesenteric ischemia or in the general surgery section of the zero definals

surgery book. So let's get straight into it. Measantiric is caused by a lack of blood flow through

the mesenteric vessels supplying the intestines and this results in intestinal ischemia.

First let's start by talking about the blood supply.

There are three main branches of the abdominal aorta that supply the abdominal organs.

And these branches are the celiac artery, the superior mesenteric artery, and the inferior mesenteric artery.

The foregut includes the stomach and part of the duodenum, the billory system, the liver,

the pancreas and the spleen, and the foregut is supplied by the celiac artery.

The mid-gut is from the distal part of the duodenum to the first part of the

transverse colon, and this is supplied by the superior mesenteric artery. And the hind gut is from

the second half of the transverse colon to the rectum, and this is supplied by the inferior mesenteric artery.

Let's talk about chronic mesenteric ischemia. Chronic mesenteric ischemia is also known as intestinal

angina, and it's the result of narrowing of the mesenteric blood vessels by atherosclerosis.

This results in intermittent abdominal pain where the blood supply cannot keep up with the demand.

It's similar to the pathophysiology of angina, where the blood supply is reduced by the coronary

artery disease resulting in intermittent symptoms.

The typical presentation of chronic mesenteric ischemia is with a classical triad of central

colicky abdominal pain after eating, which usually starts around 30 minutes after eating and

lasts for one to two hours, weight loss, which is due to food avoidance because food causes pain, and an abdominal

brewie, which may be heard on auscultation. A brewery is a wishing or a blowing sound that's

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