A 56 year old man is brought to the emergency depament with rapid onset of severe abdominal pain. But physical examination seemed to be out of propoion to his symptom. Acute mesenteric ischemia was diagnosed. What is the MOST common cause of acute mesenteric ischemia?
**Core Concept**
Acute mesenteric ischemia is a medical emergency characterized by sudden onset of intestinal ischemia, often presenting with severe abdominal pain. The most common cause of this condition is related to the blockage of blood flow to the intestines.
**Why the Correct Answer is Right**
Acute mesenteric ischemia occurs when there is a sudden reduction in blood flow to the intestines. The most common cause of this reduction is embolism, which is typically a result of a blood clot that forms in the heart or elsewhere in the body and travels to the mesenteric arteries, blocking blood flow to the intestines. This is often associated with atrial fibrillation, heart valve disease, or other conditions that increase the risk of clot formation. The embolism can also originate from other sources, such as the aorta or other large arteries.
**Why Each Wrong Option is Incorrect**
**Option A:** Aerial thrombosis is not a commonly used term in medical literature. However, arterial thrombosis can be a cause of acute mesenteric ischemia, but it is less common than embolism.
**Option B:** Venous thrombosis is a rare cause of acute mesenteric ischemia and typically presents with signs of venous obstruction, such as bowel dilatation and ascites.
**Option D:** Non-occlusive disease refers to a condition where there is no physical blockage of blood flow to the intestines, but rather a problem with the blood vessels themselves. This can be due to a variety of factors, such as vasospasm or low blood pressure, and is a less common cause of acute mesenteric ischemia.
**Clinical Pearl / High-Yield Fact**
In patients with acute mesenteric ischemia, the clinical presentation may be atypical, with abdominal pain that is out of proportion to the physical examination findings. A high index of suspicion and prompt imaging studies, such as CT angiography, are essential for diagnosing this condition.
**✓ Correct Answer: C. Embolism**