Drug therapies for mesenteric vascular disease

Mesenteric vascular disease has been increasingly diagnosed in the past 25 years. This rise in incidence has been attributed to the advanced mean age of the population and increasing number of critically ill patients, and to a greater clinical recognition of the condition. While surgical revascularization and resection has long been the standard of treatment, medical management also plays an important role. Early diagnosis before irreversible bowel damage, which may occur within 6 to 8 hours after insult, is the goal of successful medical treatment without surgical intervention. Even in the presence or irreversible bowel ischemia, perioperative medical treatment may reduce the progression of further ischemia, and bowel resection may be limited. This article outlines the appropriate medical management of ischemic disorders of the intestine, with an emphasis on the drug treatments presently used in clinical practice and those being studied in the laboratory.