Ultrasound Scan:
Mesenteric Artery Doppler

Mesenteric artery disease, also known as mesenteric ischemia, refers to the narrowing or blockage of the arteries that supply blood to the intestines, known as the mesenteric arteries. The condition leads to reduced blood flow to the intestines, which can result in tissue damage and various symptoms.

There are two main types of mesenteric artery disease:

1. Acute mesenteric ischemia: This type of mesenteric artery disease occurs suddenly and is often caused by an acute arterial blockage, such as an embolism or thrombosis. It is considered a medical emergency and requires immediate intervention. Acute mesenteric ischemia can lead to severe abdominal pain, tenderness, nausea, vomiting, and rapid development of intestinal tissue damage if not promptly treated.

2. Chronic mesenteric ischemia: Chronic mesenteric ischemia is a long-standing condition characterised by the gradual narrowing or blockage of the mesenteric arteries due to atherosclerosis, the buildup of plaque in the arterial walls. This chronic narrowing restricts blood flow to the intestines, especially during periods of increased blood demand after eating. The most common symptom of chronic mesenteric ischemia is postprandial abdominal pain (abdominal pain after meals) that is typically severe and may be associated with weight loss and fear of eating. In advanced cases, individuals may experience diarrhoea or other symptoms related to reduced blood flow to the intestines.

Mesenteric artery disease can be caused by various factors, including atherosclerosis, blood clots (embolism or thrombosis), arterial dissection, vasculitis (inflammation of blood vessels), or radiation therapy to the abdomen. The disease primarily affects older individuals and those with underlying risk factors such as smoking, diabetes, hypertension, high cholesterol, and a history of cardiovascular disease.

We request a 4 hr fast for this study.

Eating creates a gas that ultrasound is unable to scan through and may obstruct structures we need to see.

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This scan usually takes between 20- 30 minutes.

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The purpose of this ultrasound is to assess the blood flow through the mesenteric arteries in your abdomen. This ultrasound requires direct contact with your skin. The scan will assess the arteries from as high as the diaphragm to the level of the hips. We will require you to lift your jumper and shirt up and also shuffle your trousers down to the hips.

We will ask for you to lie on your back on our examination bed. During the scan we will apply ultrasound gel to your abdomen and use the ultrasound machine to look at the the arteries to assess for narrowing and blockages. You will hear noises from the ultrasound machine; this is all normal and is the sound of the blood flow moving through your arteries.

During this scan we assess the superior mesenteric artery, splenic artery, hepatic artery, coeiliac trunk, and inferior mesenteric artery. We will be looking for blockages, compression and narrowing (stenosis) and occlusions which may be affecting the amount of blood flow moving through these vessels.

Mesenteric artery disease, also known as mesenteric ischemia, occurs when the arteries supplying blood to the intestines become narrowed or blocked, leading to reduced blood flow to the intestines. Several risk factors can increase the likelihood of developing mesenteric artery disease. These risk factors include:

Atherosclerosis

Atherosclerosis is a major risk factor for mesenteric artery disease. It involves the buildup of plaques, consisting of cholesterol, fat, and other substances, within the arterial walls. Atherosclerosis can cause narrowing or blockage of the mesenteric arteries, reducing blood flow to the intestines.

Age

The risk of mesenteric artery disease increases with advancing age. Older individuals are more likely to have atherosclerosis and other vascular diseases that contribute to the development of mesenteric artery disease.

Smoking

Smoking is a significant modifiable risk factor for mesenteric artery disease. The chemicals in tobacco smoke can damage the arterial walls, promote the formation of atherosclerotic plaques, and accelerate the progression of the disease.

Diabetes

People with diabetes have a higher risk of developing mesenteric artery disease. Diabetes can contribute to the development and progression of atherosclerosis, increasing the likelihood of arterial blockages.

Hypertension

High blood pressure can damage the arterial walls and promote the development of atherosclerosis. Hypertension increases the risk of mesenteric artery disease by impairing blood flow to the intestines.

High cholesterol levels

Elevated levels of LDL cholesterol ("bad" cholesterol) and triglycerides in the blood increase the risk of atherosclerosis and subsequent mesenteric artery disease.

Obesity

Excess body weight, particularly abdominal obesity, is associated with a higher risk of mesenteric artery disease. Obesity can contribute to the development of atherosclerosis and other cardiovascular diseases.

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History of heart disease or peripheral artery disease

Individuals with a history of heart disease, such as coronary artery disease, or peripheral artery disease (PAD) are at an increased risk of developing mesenteric artery disease.

Family history

Having a family history of mesenteric artery disease or other vascular diseases can increase the risk of developing the condition. Genetic factors can influence an individual's susceptibility to atherosclerosis and related arterial blockages.

Mesenteric artery disease refers to the narrowing or blockage of the arteries that supply blood to the intestines, known as the mesenteric arteries. The condition can lead to reduced blood flow to the intestines, which can result in various symptoms. The symptoms of mesenteric artery disease may include:

Abdominal pain

The hallmark symptom of mesenteric artery disease is abdominal pain, which may be described as cramping, colicky, or severe. The pain typically occurs after eating and is often located in the middle or upper abdomen.

Weight loss

Unexplained weight loss can occur in mesenteric artery disease. Reduced blood flow to the intestines can affect the absorption of nutrients, leading to unintended weight loss.

Nausea and vomiting

Some individuals with mesenteric artery disease may experience nausea and vomiting, particularly after meals. This can be a result of compromised blood flow and decreased intestinal function.

Diarrhoea

Reduced blood flow to the intestines can cause changes in bowel movements, leading to frequent loose stools or diarrhoea.

Food fear or avoidance

The abdominal pain and associated symptoms may lead to a fear of eating or avoidance of certain foods due to the anticipation of pain or discomfort after meals.

The treatment for mesenteric artery disease, also known as mesenteric ischemia, depends on the type and severity of the condition. The primary goals of treatment are to restore adequate blood flow to the intestines, relieve symptoms, and prevent complications. Treatment options may include:

Acute Mesenteric Ischemia:

• Emergency surgery: In cases of acute mesenteric ischemia, immediate surgical intervention may be necessary. The specific procedure depends on the underlying cause and extent of the arterial blockage. Surgical options may include embolectomy (removal of blood clots), thrombectomy (removal of thrombus or clot), or revascularization procedures to restore blood flow.

• Endovascular procedures: In some cases, endovascular interventions such as catheter-directed thrombolysis or mechanical thrombectomy may be considered to restore blood flow through the blocked arteries. These procedures involve the use of catheters and specialized devices to remove or dissolve blood clots and restore blood flow.

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Chronic Mesenteric Ischemia:

• Lifestyle modifications: Making lifestyle changes can help manage chronic mesenteric ischemia and reduce the progression of atherosclerosis. These may include smoking cessation, adopting a healthy diet low in saturated fats and cholesterol, engaging in regular exercise, and maintaining a healthy weight.

• Medications: Medications may be prescribed to manage symptoms and reduce the risk of complications associated with chronic mesenteric ischemia. These can include:

• Antiplatelet agents: Medications such as aspirin or clopidogrel may be prescribed to reduce the risk of blood clot formation and improve blood flow.

• Cholesterol-lowering medications: Statins or other lipid-lowering medications may be prescribed to manage high cholesterol levels and slow down the progression of atherosclerosis.

• Blood pressure control: Medications to control hypertension may be prescribed to reduce blood pressure and minimise the risk of further arterial damage.

• Endovascular procedures: In some cases of chronic mesenteric ischemia, endovascular interventions may be considered to improve blood flow. These procedures involve the use of angioplasty and stenting to widen the narrowed or blocked arteries and improve blood flow to the intestines.

• Surgical revascularisation: In cases where endovascular procedures are not suitable or effective, surgical options such as bypass surgery may be considered. Bypass surgery involves creating a detour around the narrowed or blocked artery using a graft (artificial or natural blood vessel) to restore blood flow to the intestines.