GI

Chronic Mesenteric Ischemia

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Chronic Mesenteric Ischemia, Abdominal Angina, Intestinal Angina

  • Epidemiology
  1. Age: 60 years is mean age of diagnosis
  2. Gender predominance: Female (by ratio to 3:1)
  • Risk Factors
  • Symptoms
  1. Symptoms are typically present for 4 -6 months at presentation
    1. Diagnosis is often delayed as much as 18 months
  2. Post-prandial Abdominal Pain
    1. Crampy Abdominal Pain
    2. Pain is poorly localized
  3. Weight loss of 15-25 pounds
  • Signs
  1. Abdominal bruit (60-90%)
  2. Fecal Occult Blood Testing (10%)
  • Imaging
  • Diagnosis
  1. Angiography (gold standard)
  2. MRA Abdomen
  3. Ultrasound duplex
  • Management
  1. Vascular Surgery
  2. Endovascular procedures
  • References
  1. Fraboni (2012) Board Review Express, San Jose