Vascular Diseases of the Gastrointestinal Tract

Chronic gastrointestinal ischemia (CGI) results from insufficient blood supply to the stomach, small intestine and colon. In most cases this is caused by stenosis of the supplying arteries with lack of sufficient collateral circulation. Most often the stenosis is due to atherosclerosis [1], but other non-occlusive causes are also known [2, 3]. Three direct branches of the abdominal aorta are responsible for the arterial blood supply of the gastrointestinal tract: the celiac artery (CA), the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA).

CGI is a diagnostic challenge. Currently, there is no single test with high sensitivity and specificity to diagnose or exclude this condition.

The aim of this thesis is to explore various aspects and diagnostic methods for the detection of CGI, by means of functional testing using VLS, a prediction model for CGI, and hypoxia-inducible factor-1α (HIF-1α) as a marker for CGI. This is followed by studies of CGI due to portal vein thrombosis and CGI induced liver injury. Furthermore, treatment of other vascular diseases of the gastrointestinal tract such as variceal bleeding, are discussed.