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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the results of a series of patients who had isolated or associated reimplantation of the superior mesenteric artery directly into the infrarenal aorta. Between 1967 and 1988, a total of 91 revascularizations for atheromatous lesions of the visceral arteries were performed in 89 patients. The superior mesenteric artery was reconstructed in 87 instances, 60 of which were direct or indirect reimplantations into the juxtarenal aorta. The procedure was isolated in 51 cases, and associated with the revascularization of another visceral artery in nine cases. These 60 patients were divided into three groups: Group A--seven patients undergoing emergency operation for acute intestinal ischemia; Group B--30 patients operated upon for chronic intestinal angina; and Group C--22 asymptomatic patients who underwent prophylactic revascularization. Two patients died in the immediate postoperative period (3.5%). Although most of the 29 late deaths were due to vascular disorders, only one was secondary to intestinal infarction. Twenty-one patients followed had good functional results; six patients had relapse of abdominal pain. Three of these underwent repeat revascularization of the superior mesenteric artery 12 days, 18 months, and 22 months, postoperatively. Follow-up ranged from six months to 18 years. Two patients were lost to follow-up. Overall actuarial survival at five years was 69.60 +/- 15%. In our experience, isolated reimplantation of the superior mesenteric artery on the anterior aspect of the infrarenal aorta is a simple and reliable technique which affords good long-term results.
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PMID:Aortic reimplantation of the superior mesenteric artery for atherosclerotic lesions of the visceral arteries: sixty cases. 231 Jun 64

The syndrome of intestinal angina is rare and can be effectively treated by revascularization of the obstructed arteries. Usually the time from onset of symptoms to diagnosis is several months. Because of abdominal pain and loss of weight, abdominal malignancy is often suspected. At present there is no specific diagnostic test, and angiography with two projections is necessary. During the last decade 373 patients with intestinal angina have been reported. Our group presents two patients who have been operated on. After a follow-up of 18 and 19 months respectively, they are still without symptoms.
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PMID:[Chronic intestinal ischemia]. 233 76

We report our experience in the surgical treatment of visceral arterial occlusive disease in 9 patients. The etiology was atherosclerosis in 7 cases and arteritis in 2. Four patients were admitted because of acute mesenteric ischemia, but only two had a previous history of intestinal angina. Four consulted because of chronic mesenteric angina and only 1 asymptomatic patient received prophylactic revascularization. The clinical picture of postprandial abdominal pain, weight loss, bowel habit disturbance, abdominal bruit or signs of occlusive disease elsewhere, should lead to clinical diagnosis. Angiographic evaluation is mandatory to plan the best surgical approach. In this series we revascularized 14 vessels in 9 patients using different technics. Two patients died (42 and 90 days) following revascularization and partial resection of the gut for extensive infarction. All survivors achieved symptom relief and or recovered or stabilized their weight.
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PMID:[Mesenteric vascular insufficiency caused by chronic occlusive disease: experience with the surgical management of 9 cases]. 251 15

Since the turn of the century, recurrent abdominal pain (RAP) has been a diagnostic dilemma. From the fifties, the work of Apley led to a shift in the thinking i.e., away from organic to psychosomatic causes for the pain. During the past decade, however, better gastroenterological studies have led to a return to a search for organic causes. Psychologically, this may prove salutory to the child with RAP. Based on the history, glucose tolerance and histopathological studies reported elsewhere by the authors, it is suggested that the pain in these children is due to intestinal angina. The angina may be consequent to the master switch of life operating as a glucose homeostatic mechanism in mild viral infections. The role of intravenous glucose in such situations is discussed.
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PMID:Pathogenesis and rationale of treatment of recurrent abdominal pain. 734 67

The authors report the cases of two patients presenting a symptomatic intestinal angina caused by median arcuate ligament compression. Arteriography demonstrates severe coeliac artery stenosis in both of them and a retrograde filling of the coeliac axis from the superior mesenteric artery branch collateral vessels. The patients became asymptomatic after surgical release of the celiac trunk by section of the median arcuate ligament of the diaphragm. At 2 and 3 years follow-up, both patients report no further abdominal pain. Dunbar's syndrome is still a questionable subject; how can be a narrowing or an occlusion of the celiac artery semeiotically and clinically important? Some have proposed an ischemic base to explain the abdominal pain: the compression of the celiac trunk could be responsible of a celiac steal which results in shunting of blood from the superior mesenteric artery to the celiac distribution through the collateral system. There are very strong proofs that partial or even complete obstruction of the celiac artery should not lead to visceral ischemia such as: the rich collateral anastomosis of the celiac axis, the surgical ligation of the celiac axis performed without untoward consequences, the finding of asymptomatic celiac stenosis in the 49% of an arteriographic study, impossibility to formulate a consistent and rational for the surgical results. Shearing this view, few authors would prove that a stenotic type of the celiac artery is only a normal anatomic variant, refuting the existence of this syndrome.
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PMID:[Dunbar's syndrome: clinical reality or physiopathologic hypothesis?]. 900 67

Chronic ischemia of the small bowel is classically described as presenting with abdominal pain associated with eating (intestinal angina). Here we describe the cases of two patients with chronic small bowel ischemia who presented atypically with painless watery diarrhea and weight loss. These cases suggest that the clinical spectrum of chronic small bowel ischemia may be wider than previously appreciated. Chronic ischemia of the small bowel should be included in the differential diagnosis for painless watery diarrhea in the context of weight loss.
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PMID:Painless small bowel ischemia presenting with diarrhea and weight loss. 957 68

Abdominal pain is by far the most serious symptom in attacks of acute intermittent porphyria. Its cause is unknown. This case study suggests visceral ischaemia as a possible cause of the abdominal pain. A 31-year-old woman with recurrent bouts died during an attack; the autopsy revealed a 20-cm necrotic gangrene in the ileum. A protracted intestinal vasospasm could have been the immediate cause of death. It is discussed whether intestinal angina could be the cause of the abdominal pain in acute intermittent porphyria.
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PMID:Could attacks of abdominal pain in cases of acute intermittent porphyria be due to intestinal angina? 1076 59

Abdominal pain is by far the most serious symptom in attacks of acute intermittent porphyria (AIP). Its cause is unknown. This case suggests visceral ischemia as a possible cause of the abdominal pain. A 31-year-old woman with recurrent bouts died during an attack; the autopsy revealed a 20 cm necrotic gangrene in the ileum. A protracted intestinal vasospasm could have been the immediate cause of death. The question as to whether intestinal angina could be the cause of abdominal pain in acute intermittent porphyria is discussed.
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PMID:[Unsatisfactory pain treatment in attacks of acute intermittent porphyria. Vasodilation an alternative if the pain is shown to be the pain of intestinal angina]. 1129 73

Abdominal angina (AA) is an infrequently occurring syndrome characterized by postprandial abdominal pain due to reduced blood flow to organs in the territory of the celiac trunk, superior mesenteric artery (SMA), and inferior mesenteric artery. Multi-detector row computed tomographic (CT) angiography with four- or 16-row scanners has become a primary tool for the evaluation of patients with suspected steno-occlusive diseases of the abdominal vessels. In patients with suspected AA, multi-detector row CT angiography can help evaluate the presence and degree of stenosis in the celiac trunk and SMA, demonstrate the collateral circulation, and help exclude other causes of vascular obstruction. It also allows visualization of small vessels and of vessel wall abnormalities in the absence of significant stenosis. Vessels with a complex anatomic configuration can easily be visualized with proper postprocessing techniques. This modality can also be used to follow up patients who have undergone percutaneous interventional treatment. Limitations include the lack of dynamic representation of flow abnormalities and difficulty in evaluating heavily calcified vessels. Nevertheless, multi-detector row CT angiography with appropriate postprocessing techniques is highly effective for the diagnosis, evaluation, and treatment of suspected AA. Additional studies will help further evaluate the performance and applications of this modality.
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PMID:Multi-detector row CT angiography in patients with abdominal angina. 1525 21

The authors report the case of a rare mesenteric anomaly in a 71-year-old man who presented with a preexisting abdominal aortic aneurysm (AAA) and a progressive history of postprandial abdominal pain and 10-lb weight loss. Aortography revealed a common celiomesenteric trunk, an absent middle colic artery, and a stenotic inferior mesenteric artery. At operation, neural fibers compressing the common celiomesenteric trunk were lysed, the AAA was repaired, and the inferior mesenteric artery was subjected to endarterectomy and then reimplanted. The patient remains well and free of symptoms 1 year after operation. This rare case demonstrates the many different causes of intestinal angina and its surgical relief.
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PMID:Celiomesenteric trunk compression and absence of collateral vessels in the large intestine--a case report. 1549 45


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