Chest and abdominal pain are the most common reasons that persons aged 15 years and over visit the emergency department. Abdominal angina, like the cardiac angina, is due to ischemia of the mesenteric arteries.
- Mesenteric vascular disease
- Ischemic colitis; Ischemic bowel - mesenteric
- Atherosclerosis - mesenteric artery
Mesenteric artery ischemia occurs when there is a narrowing or blockage of one or more of the three major arteries that supply the small and large intestines. These are called the mesenteric arteries.
History and physical examination
Midepigastric or central abdominal pain within 10–15 minutes after eating in history. Also ask for smoking history, family history, and any history of other vascular disease such as coronary artery disease and or peripheral vascular disease.
The abdomen typically is scaphoid and soft, even during an episode of pain.
Patients present with stigmata of weight loss and signs of peripheral vascular disease, particularly aortoiliac occlusive disease, may be present.
- Smoking is an associated risk factor.
- In most series, approximately 75–80% of patients smoke.
The underlying vascular pathophysiology is similar to that seen in angina pectoris and intermittent claudication with atherosclerosis.
Mesenteric vessel atherosclerosis
The most common cause of abdominal angina is atherosclerotic vascular disease, where the occlusive process commonly involves the ostia and the proximal few centimeters of the mesenteric vessels.
It can be associated with:
- Internationally: Extremely rare. True incidence is unknown
- Race: No data available
- Sex: Females outnumber males by approximately 3 to 1
- Age: Mean age of affected individuals is slightly older than 60 years
It is diagnosed with a combination of clinical history characterized by abdominal pain within 15-20 minutes of eating, and other studies such as the following:
- A Doppler ultrasound or CT angiogram scan may show problems with the blood vessels and the intestine.
- A mesenteric angiogram is a test that involves injecting a special dye into your bloodstream to highlight the arteries of the intestine.
- Then x-rays are taken of the area. This can show the location of the blockage in the artery.
Vascular stents have been used in the treatment of abdominal angina.
|Health science - Medicine - Gastroenterology - edit|
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