clinical features
Last reviewed 01/2018
The patient with an acute occlusion to their superior mesenteric artery may present with a sudden onset, severe colicky abdominal pain. The patient is classically elderly and has a past history of cardiac or arterial disease. Occasionally, the pain is vague and insidious.
Vomiting and diarrhoea can develop, and both may have a bloody element due to slow haemorrhage into the bowel lumen.
Physical signs are minimal initially and the patient is classically noted at this time to have pain out of proportion to the examination findings. However, as necrosis passes outwards from the mucosa, guarding, tenderness, abdominal distention and an absence of bowel sounds are apparent. Shock is a late sign.