Mesenteric ischemic diseases

　　Mesenteric vascular ischemic diseases can be caused by the following reasons, such as:

　　1. Superior mesenteric artery embolism, the embolus is often derived from the heart, such as wall thrombus after myocardial infarction, valvular heart disease, atrial fibrillation, endocarditis, etc. It can also come from atherosclerotic plaques on the aorta wall; embolism can occur at the orifice of the superior mesenteric artery, more commonly in the distal narrow part, with the common site below the orifice of the middle colic artery.

　　2. Superior mesenteric artery thrombosis usually occurs on the basis of arteriosclerotic obstruction or stenosis, often involving the entire superior mesenteric artery, with some localized cases.

　　3. Superior mesenteric vein thrombosis can be secondary to abdominal infection, portal hypertension due to liver cirrhosis, stasis of blood flow, polycythemia vera, hypercoagulable state, and vascular injury caused by trauma or surgery.

　　Mesenteric vascular ischemic diseases can affect the entire gastrointestinal tract. However, the left half of the colon is more common, especially the splenic flexure of the colon, which is due to the fact that the splenic flexure is supplied by the terminal anastomosis of the superior and inferior mesenteric arteries, which has the weakest ability to resist ischemia and is prone to insufficient blood supply.

　　The clinical manifestations vary according to the nature, location, extent, and onset of mesenteric vascular obstruction. Generally, the more acute the onset process, the wider the scope, and the more severe the manifestation. The symptoms of arterial obstruction are more acute and severe than those of venous obstruction. The clinical manifestations of superior mesenteric artery embolism and thrombosis are roughly similar. They usually have an acute onset, with early symptoms of sudden onset of severe abdominal colic, frequent nausea and vomiting, and diarrhea. The abdomen is flat and soft, with mild tenderness, and bowel sounds are active or normal. The characteristic is that severe symptoms are not commensurate with mild signs. The systemic changes are not obvious, but if the range of vascular occlusion is extensive, shock may appear earlier. With the development of intestinal necrosis and peritonitis, abdominal distension becomes more obvious, bowel sounds disappear, and peritoneal irritation signs such as abdominal tenderness and muscle tension appear. Dark red hemorrhagic fluid is vomited, or hematochezia occurs; the fluid aspirated from the abdominal puncture is also hemorrhagic. Hematology often shows hemodilution, with a significantly elevated white blood cell count in the early stage of the disease, often above 20×10^9/L.

　　Patients with superior mesenteric artery thrombosis often have signs of chronic superior mesenteric artery ischemia first. These signs include abdominal pain after a heavy meal, leading to the patient's reluctance to eat and gradual weight loss, accompanied by symptoms of chronic diarrhea and malabsorption of the intestines. When sudden thrombosis causes acute complete vascular obstruction, the symptoms are similar to those of superior mesenteric artery embolism. The symptoms of superior mesenteric vein thrombosis develop more slowly, with many having prodromal symptoms such as abdominal discomfort, constipation, or diarrhea. After several days to several weeks, there may be sudden severe abdominal pain and persistent vomiting, but hematemesis and melena are more common, accompanied by abdominal distension and abdominal tenderness. The bowel sounds are reduced. Abdominal puncture can yield hemorrhagic fluid, and there is often fever and an elevated white blood cell count.

　　The blood vessels throughout the body are like the water and gas pipelines in residential buildings. After long-term use, the inner wall of the pipes is prone to scaling and rusting. Some bad habits can accelerate the aging of blood vessels. To prevent mesenteric ischemic disease, the following points are mainly involved:

　　Firstly, in the blacklist of 'enemies' of blood vessels, the following 5 have the strongest killing power:

　　1. 'Four highs' diet blocks blood vessels. The 'four highs' diet, including high sugar, high fat, high cholesterol, and high salt, can be said to be the number one 'enemy' of blood vessels. They increase the risk of hypertension and are also prone to cause cholesterol and blood lipids to adhere to the blood vessel wall, causing atherosclerosis and leading to poor blood vessel patency.

　　2. Long-term staying up late can strain the blood vessels. Long-term staying up late leads to the secretion of hormones such as adrenaline, which can cause an increased heart rate and blood pressure, thereby increasing the pressure on the cardiovascular system. If you have poor rest continuously, plus emotional anxiety, blood pressure fluctuations, it is easy to trigger a stroke or sudden death.

　　3. Smoking can easily 'poison' the blood vessels. Tobacco is widely recognized as a major enemy of cardiovascular health. The harmful substances in tobacco smoke can easily induce coronary spasm, cause myocardial ischemia and hypoxia, and also accelerate the process of atherosclerosis, making thrombosis more likely.

　　4. Lack of aerobic exercise, and the blood vessels are filled with garbage. Prolonged sitting leads to weight gain, which increases the burden on the heart, affects heart blood circulation, and these can indirectly trigger hypertension and worsen coronary heart disease. Long-term inactivity causes garbage in the blood vessels to accumulate gradually, forming atherosclerotic plaques. In fact, even walking, due to the compression of leg muscle contraction, can enhance the elasticity of blood vessels.

　　5. Accumulate bad mood, and the blood vessels lose vitality. Mental stress can cause the contraction of blood vessel intima, accelerate the aging of blood vessels. Often being angry and under pressure can make blood vessels harden easily. In fact, many cardiovascular and cerebrovascular diseases are related to excessive emotional fluctuations. To have healthy blood vessels, maintaining a good attitude is the simplest and most economical method.

　　Secondly, how should we defeat these 5 'enemies':

　　In simple terms, it is a sentence: eat to 80% of fullness, walk ten thousand steps a day, balance eating and exercise.

　　1. Eat some 'blood cleansers'. Hawthorn, oatmeal, black fungus, tangerine, eggplant, sweet potato, garlic, and onion are the eight foods that can unblock blood vessels and maintain the elasticity of the vascular wall. Vinegar can also soften blood vessels and reduce blood lipids. Of course, the most important thing is to adhere to a balanced diet, eat more vegetables and fruits, and be vigilant about 'four high' foods.

　　2. Maintain continuous exercise without slacking off. British research has found that long-term, continuous exercise can significantly improve the vascular function of patients with cardiovascular diseases and even prevent the recurrence of myocardial infarction. Many cardiovascular and cerebrovascular experts are skilled in exercising, such as Professor Hu Dayi, who has been adhering to the 'walk ten thousand steps a day' for 12 years, even when he was in the Ali Plateau region of Tibet. Mild exercises such as jogging and brisk walking are suitable for most patients.

　　3. Consume two pieces of dark chocolate every week. Dark chocolate contains natural antioxidants called flavonoids, which can prevent the hardening of blood vessels, increase myocardial vitality, relax muscles, prevent cholesterol accumulation in blood vessels, and have certain effects on the prevention and treatment of cardiovascular diseases.

　　4. Drink green tea less alcohol. Catechins in green tea can reduce the content of bad cholesterol in the blood, enhance the flexibility and elasticity of blood vessels, and prevent vascular sclerosis. It is not recommended to drink alcohol to protect blood vessels. Excessive alcohol consumption can increase blood pressure and blood triglycerides, leading to atrial fibrillation, alcoholic cardiomyopathy, fatty liver, liver cirrhosis, and even sudden death in severe cases.

　　The diagnosis of mesenteric ischemic diseases mainly relies on medical history and clinical manifestations. Abdominal X-ray films show mild or moderate expansion and distension of the involved small intestine and colon. In the late stage, due to a large amount of fluid in the intestinal lumen and abdominal cavity, the X-ray film shows general increased density in the abdomen. Selective arteriography is of great significance for diagnosis, and it can help differentiate between vascular embolism, thrombosis, or spasm in the early stage, and can also be given vasodilators and other treatments at the same time.

　　Patients with mesenteric ischemic diseases should eat foods that are good for clearing the blood vessels, such as hawthorn, oatmeal, black fungus, tangerine, eggplant, sweet potato, garlic, and onion. These eight foods are the most effective in clearing blood vessels and maintaining the elasticity of the blood vessel wall. Vinegar can also soften blood vessels and reduce blood lipids. Of course, the most important thing is to adhere to a balanced diet, eat more vegetables and fruits, and be vigilant about 'four high' foods. Hawthorn, oatmeal, black fungus, tangerine, eggplant, sweet potato, garlic, and onion are the eight foods that are the most effective in clearing blood vessels and maintaining the elasticity of the blood vessel wall. Vinegar can also soften blood vessels and reduce blood lipids. Of course, the most important thing is to adhere to a balanced diet, eat more vegetables and fruits, and be vigilant about 'four high' foods.

　　Early diagnosis and treatment are essential for mesenteric ischemic diseases, including supportive therapy and surgical treatment. Mesenteric artery thrombectomy can be performed for mesenteric artery embolism, and thrombectomy or mesenteric artery-aorta bypass surgery can be performed for thrombosis. If there is intestinal necrosis, an intestinal resection should be performed. Mesenteric vein thrombosis requires an intestinal resection, and the extent of resection should include all mesentery with venous thrombosis, otherwise there is a possibility of postoperative venous thrombosis progression. Anticoagulation therapy should also be continued after surgery. Acute mesenteric ischemic diseases are often misdiagnosed due to insufficient understanding in clinical practice, and once extensive intestinal obstruction and necrosis occur, the prognosis is severe, and the mortality rate is very high.