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

Chronic mesenteric ischemia often called intestinal angina too, is the clinical syndrome that originates as a result of chronic obstruction of the splanchnic arteries. Intestinal angina is defined by the clinical triad of postprandial abdominal pain, sitophobia (fear of eating) and chronic weight loss. Postprandial abdominal pain is analogous to angina pectoris and calf claudication, two more common manifestations of episodic tissue hypoxia. The authors present the case-history of a 50-year-old woman with intestinal angina due to obliteration of the all three main splanchnic arteries. The authors describe the course of the disease and point out new diagnostic approaches in the diagnosis of chronic mesenteric ischemia (Doppler ultrasound of the splanchnic arteries, helical CT angiography of the splanchnic vasculature). In the discussion they point out the possible atypical clinical manifestation of chronic mesenteric ischemia and existence of gastric ulceration and chronic ischemic gastritis caused by chronic mesenteric ischemia.
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PMID:[Chronic mesenteric ischemia]. 1563 5

Chronic mesenteric ischemia is an unusual but important cause of abdominal pain. Although this condition accounts for only 5% of all intestinal ischemic events, it can have significant clinical consequences. Among its many causes, atherosclerotic occlusion or severe stenosis is the most common. This disorder has an indolent course that results in extensive collateral vascular formation. Thus, symptoms occur when at least two of the three main splanchnic vessels are affected. Intestinal angina, weight loss, and sitophobia are common clinical features. Diagnosis can often be made by noninvasive methods such as computerised axial tomographic angiography, magnetic resonance angiography, and duplex ultrasonography as well as by invasive catheter angiography. Therapy of chronic mesenteric ischemia depends on the extent and location of vascular disease. Alternatives to traditional surgical bypass are becoming more common including embolectomy, thrombolysis, and percutaneous angioplasty with vascular stenting. Early intervention is vital as the natural course of this illness can be debilitating. Furthermore, this has potential to develop into life-threatening acute mesenteric ischemia with subsequent bowel infarction and death. Long-term studies have shown that the risk of developing symptoms from asymptomatic but significant mesenteric vascular disease is 86% with overall 40% mortality rate. The recognition and management of this unusual but important cause of abdominal pain is discussed in detail in this review.
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PMID:Chronic mesenteric ischemia. 1583 94

Abdominal angina and fear of eating are manifestations of mesenteric ischemia. This infrequent cause of abdominal pain was diagnosed in a 60-year-old female smoker. We performed a novel side-to-side aorto-mesenteric anastomosis for mesenteric revascularization, with good short-term (6 months) result.
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PMID:Side-to-side aorto-mesenteric anastomosis for management of abdominal angina. 1642 23

Intestinal angina is a rare affection with a high morbidity-mortality rate if not diagnosed. It is characterized by abdominal pain and postprandial vomiting, weight loss and anorexia. Arteriography allows confirmation of the diagnosis. The following case is a typical example of its clinical presentation and surgical treatment. Different techniques of revascularisation in case of a stenosis of the main digestive arteries are discussed.
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PMID:[Chronic intestinal angina and bypass revascularization: a case report]. 1656 12

Clinical manifestations of chronic mesenteric ischemia (CMI) can range from vague abdominal pain to debilitating states of intestinal angina resulting in significant weight loss and morbidity. Once the condition has been diagnosed, treatment usually is elective, except in rare cases of rapid progression to acute mesenteric ischemia. Medical management of CMI is mostly supportive. However, in disorders of coagulation, antiplatelet agents and warfarin may be helpful to prevent further thrombosis, and these disorders may require lifelong therapy. For decades, the mainstay of therapy for CMI has been surgery. Extensive disease often requires complete revascularization, although bypass of the superior mesenteric artery alone also has been shown to be effective. Multiple variations of surgical bypass have been advocated but require further evaluation to determine efficacy. Transaortic endarterectomy is a viable option for limited disease. Minimally invasive vascular procedures such as percutaneous endovascular angioplasty and stenting are proving to be effective for short-segment atherosclerotic stenosis, particularly near the origin of the vessels. Although endovascular therapy has less long-term durability compared with open surgical procedures, these treatments prove simpler, with shortened hospital stays and reduced morbidity. Furthermore, angiographic therapy is a feasible alternative for patients in whom surgery is deemed precarious.
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PMID:Chronic mesenteric ischemia. 1729 59

Chronic intestinal ischaemia is a relatively rare but very important clinical entity, which is caused by a reduction in the splanchnic blood flow, most often because of atherosclerosis. Intestinal angina is postprandial abdominal pain developing when the genuine and collateral vessels no longer are able to accommodate the postprandial increasing demand from the gastrointestinal tract and the liver. In addition, the clinical picture very often includes sitophobia and weight loss. In daily clinical practice, conventional angiography is considered as the gold standard, but ultra sonography, computerized tomography and magnetic resonance angiography are gaining momentum when investigating for chronic intestinal ischaemia. These methods depend on imaging of the stenotic vessels not taking into consideration the possibility of sufficient splanchnic perfusion in spite of severely stenotic or occluded vessels. Only a few papers address the physiological consequence of stenotic or occluded vessels - the lack of postprandial increase in splanchnic blood flow.
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PMID:Chronic intestinal ischaemia: diagnosis. 1800 64

Abdominal angina is an underrecognized cause of postprandial abdominal pain and weight loss. Diagnosis is often delayed and requires both a careful exclusion of more common causes and a high degree of clinical suspicion, based on the patient's age, the coexistence of multiple risk factors for atherosclerosis, and the presence of vasculopathy in other districts. Appropriate investigations include duplex ultrasound, traditional angiography, magnetic resonance angiography, computed tomography angiography, and tonometry. The purpose of this review is to discuss the pathophysiology and clinical presentation of chronic mesenteric ischemia and to suggest a diagnostic flowchart for this complex condition.
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PMID:Abdominal angina. 1979 3

We report a patient with systemic lupus erythematosus (SLE) who developed progressive emaciation and postprandial abdominal pain with a 27-year history of corticosteroid treatment. The patient was diagnosed as having intestinal angina based on computed tomography that showed severe stenosis of the superior mesenteric artery (SMA) in addition to complete occlusion of the celiac and inferior mesenteric arteries. Histopathology of the SMA and abdominal aorta showed atherosclerosis with no vasculitis or thrombus formation. Intestinal angina should actively be considered as a possible cause of recurrent abdominal pain in SLE patients, particularly in those with a long history of disease.
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PMID:Intestinal angina due to atherosclerosis in a 45-year-old systemic lupus erythematosus patient. 2093 Apr 50

Abdominal angina refers to abdominal pain in which perfusion to digestive tissues has been compromised, usually due to mesenteric atherosclerosis. Pathology can progress to necrosis of vital viscera, sepsis, or even death. Practitioners need to be aware of this serious medical condition, especially in the ever-growing elderly population.
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PMID:Diagnosis and treatment of abdominal angina. 2093 81

Mesenteric ischemia is classified as either acute or chronic. The former is a life-threatening emergency in which a sudden reduction in intestinal blood flow may ultimately result in bowel infarction. The most common causes are arterial embolism, arterial thrombosis, nonocclusive mesenteric ischemia, and mesenteric venous thrombosis. A high index of suspicion, early diagnosis and rapid intervention are necessary so that normal mesenteric perfusion is restored before fatal bowel infarction can occur. Chronic mesenteric ischemia is usually caused by stenotic or occlusive disease involving the proximal segments of the mesenteric arterial supply to the bowel, usually as a result of atherosclerosis. Intestinal angina is the classic presentation, defined as recurrent postprandial abdominal pain that subsides in 1 to 2 hours, with associated weight loss and aversion to food. When combined with the clinical presentation, physical examination, and laboratory data, imaging plays a key role in the diagnosis of either acute or chronic mesenteric ischemia. Recognition of pertinent imaging findings and various treatment options may aid in preventing the serious and possibly fatal sequelae that may occur in cases of mesenteric ischemia.
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PMID:Mesenteric ischemia. 2132 62


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