{"id":6805,"date":"2021-09-14T20:00:40","date_gmt":"2021-09-14T18:00:40","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/gastrointestinal-system\/ischemic-bowel-disease-and-hemorrhoids\/"},"modified":"2021-09-14T20:05:21","modified_gmt":"2021-09-14T18:05:21","slug":"ischemic-bowel-disease-and-hemorrhoids","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/gastrointestinal-system\/ischemic-bowel-disease-and-hemorrhoids\/","title":{"rendered":"Ischemic bowel disease and hemorrhoids"},"content":{"rendered":"\n

Blood supply<\/h4>\n<\/span>\n\n\n
  • Celiac artery<\/li>
  • Superior mesenteric artery<\/li>
  • Inferior mesenteric artery<\/li><\/ul>\n\n\n\n

    Blood vessels form arcades — collateral and dual <\/strong>blood supply — in case of ischemia — red infarct<\/strong>. Can arise due to arterial or (rarely) venous occlusion.<\/p>\n\n\n\n

    • Mucosal<\/li>
    • Mural<\/li>
    • Transmural — Most often due to a severe acute obstruction<\/li><\/ul>\n\n\n<\/span>\n

      Causes<\/h4>\n<\/span>\n\n\n
      • Aortic aneurysm<\/li>
      • Severe atherosclerosis<\/li>
      • Systemic embolus<\/li>
      • Shock<\/li>
      • Vasculitis<\/li>
      • CMV<\/li><\/ul>\n\n\n<\/span>\n

        Pathogenesis<\/h4>\n<\/span>\n\n\n

        Two phases — hypoxic injury<\/strong>, followed by reperfusion injury <\/strong>(which is much more destructive, due to free radicals and inflammatory mediators).<\/p>\n\n\n\n

        • Watershed zones — Zones vulnerable to ischemia, as they are at the end of the arterial supply — the splenic flexure<\/strong>, sigmoid colon<\/strong>, and rectum<\/strong><\/li>
        • Microvasculature patterns — The crypts (of Lieberkuhn) are the first to receive blood supply, and therefore, are last to die in case of ischemia, leaving the villiary surface epithelium at most risk of dying<\/li>
        • Necrotizing enterocolitis — The most common acquired GI emergency of newborns, especially of those born preterm — an idiopathic disorder of the small and large intestine, associated with ischemia<\/li>
        • Angiodysplasia — Small vascular malformation within the intestinal wall, mostly the right colon, appearing in older adults, and can cause bleeding<\/li><\/ul>\n\n\n<\/span>\n

          Hemorrhoids<\/h4>\n<\/span>\n\n\n

          Dilated anal and perianal veins forming a porto-caval anastomosis, in the case of hemorrhoidal plexus hypertension or portal hypertension.<\/p>\n\n\n\n

          • Tend to bleed<\/li>
          • Types:
            • Internal hemorrhoids
              • Arising from the superior hemorrhoidal plexus in the distal rectum<\/li><\/ul><\/li>
              • External hemorrhoids
                • Inferior to the anorectal line<\/li>
                • Prone to prolapse<\/li><\/ul><\/li><\/ul><\/li><\/ul>\n<\/span>

                  Blood supply<\/h4>

                  Causes<\/h4>

                  Pathogenesis<\/h4>

                  Hemorrhoids<\/h4><\/div>","protected":false},"excerpt":{"rendered":"

                  Blood supply Celiac artery Superior mesenteric artery Inferior mesenteric artery Blood vessels form arcades — collateral and dual blood supply — in case of ischemia — red infarct. Can arise due to arterial or (rarely) venous occlusion. Mucosal Mural Transmural — Most often due to a severe acute obstruction Causes Aortic aneurysm Severe atherosclerosis Systemic embolus Shock Vasculitis […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":404,"menu_order":6,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6805","page","type-page","status-publish","hentry"],"yoast_head":"\nIschemic bowel disease and hemorrhoids – Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/gastrointestinal-system\/ischemic-bowel-disease-and-hemorrhoids\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" 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