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Vascular Disorders of the Intestine

Richard Warren, MD
Arch Surg. 1972;104(5):725. doi:10.1001/archsurg.1972.04180050099026.
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The mesenteric circulation is the largest regional circulation in the body, demanding one third of the cardiac output and having a potential capacity of the total blood volume. Up to ten years ago we recognized as important clinical entities only mesenteric arterial thrombosis, embolism, mesenteric venous thrombosis, and the poorly documented syndrome of intestinal angina.

In recent years, however, new pathophysiologic entities have come into focus. One of these is intestinal ischemia, and even gangrene, without apparent organic vascular occlusion. Another is the small infarction of varying etiology resulting first in hemorrhage, then in ulcer, and finally in healing with or without cicatrix, thus explaining the pathogenesis of previously obscure cases of localized "colitis." How reminiscent this is of the days, as recent as 50 years ago, when senile gangrene of the toes was, for lack of a concept of the disease of arteriosclerosis, due to "angiitis."

But the momentum


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