<prompt> All are true about acute mesenteric ischemia except:Branch point of middle colic artery is most common location for embolismAcute venous thrombosis is best judged on CTNon-obstructive mesenteric ischemia has very good prognosisGold standard investigation is angiography  <response>: Ans. c Nonobstructive mesenteric ischemia has very good prognosis Branch point of middle colic artery is the most common site for embolism causing obstruction in acute mesenteric artery ischemia. IOC for acute mesenteric ischemia: Laparotomy IOC for chronic mesenteric ischemia: Arteriography IOC for mesenteric vein thrombosis: CECT abdomenNonocclusive mesenteric ischemiaMesenteric vein thrombosis20 of acute mesenteric ischemia cases5-15 of mesenteric ischemia causesFeatures are similar to mesenteric artery thrombosis but the vessels are patentSuperior mesenteric vein SMV is most common involved which may even extend to portal vein, IMV is sparedPathophysiology: Splanchnic vasoconstriction due to hypoperfusionHypoperfusion may occur due to drugs, decreased cardiac output, renal or hepatic disease.BP falls below 40mmHg Past history of thromboembolism is seen Predisposed by hypercoagulable states Most common presentation -- Colicky abdominal pain 50 will have occult blood in stoolsArteriogram -- diffuse spasm and narrowing of SMA branches. String of lakes appearanceIOC -- CECT abdomenHas very bad prognosisHas very bad prognosis. Mortality 50 