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**11** 

*Germany* 

**Mesenteric Vascular Disease** 

*Academic Teaching Hospital of the Justus-Liebig-University, Giessen* 

Mesenteric ischemia occurs when perfusion of the visceral organs fails to meet normal metabolic requirements. This disorder is categorized as either acute and chronic, based on the duration of symptoms. Acute mesenteric ischemia (AMI) occurs rapidly over hours to

The celiac artery arises from the abdominal aorta just caudal to the diaphragm at the level of L1 and is bordered by the median arcuate ligament at the aortic hiatus superiorly and the superior border of the pancreas inferiorly.Traditionally, the three branches from this common trunk include the left gastric, splenic, and common hepatic arteries. However, multiple variations of the true "trifurcation" can exist. Most frequently, the common hepatic

The SMA arises a few centimeters caudal to the celiac trunk, and its origin is crossed by the

The IMA is usually located 3 to 4 cm cephalic to the aortic bifurcation, just to the left of

The most common cause of AMI is embolization to the SMA. Arterial emboli are responsible for 40% to 50% of cases of AMI (2, 3, 4).The proximal source of the embolus is frequently intracardiac mural thrombus. Mural thrombus in proximal aneurysms in the thoracic or proximal abdominal aorta can also serve as embolic sources. Because the SMA arises at a less acute angle from the abdominal aorta compared with the other mesenteric vessels, it appears to be the most common final destination for mesenteric emboli. Additionally, such emboli tend to lodge several centimeters from the vessel's origin, usually distal to the middle colic artery.

Arterial thrombosis constitutes the next most common cause of AMI and occurs in 20% to 35% of cases (4, 5). Preexisting atherosclerotic plaque affecting all visceral vessels is the

artery and its branches arise from the SMA or directly from the abdominal aorta (1).

midline, and usually arises at the level of the third lumbar vertebra.

days and frequently leads to acute intestinal infarction requiring resection.

**1. Introduction** 

**2. Anatomy of the visceral arteries** 

neck of the pancreas and the splenic vein.

**2.1 Acute mesenteric ischemia** 

**2.1.2 Arterial thrombosis** 

**2.1.1 Embolism** 

Amer Jomha and Markus Schmidt

*Klinikum Bad Hersfeld,* 

mycotoxins from food. *Food Chemistry and Toxicology*, Vol. 43, No. 1, (January 2005), pp. 31-40, ISSN 0278-6915

