Mesenteric Ischemia
Chronic mesenteric ischemia (CMI) is due to inadequate perfusion of the abdominal organs (small and large bowels) from blockages that develop in the arteries secondary to hardening of arteries or arteriosclerosis. These blockages result in symptoms such as abdominal pain after eating, weight loss, nausea and vomiting, and diarrhea. The diagnosis of CMI is often delayed due to the pursuit of other diagnoses, such as cancer, peptic ulcer disease, gallstones and other abdominal organ pathology. The first line of diagnosis of CMI is duplex ultrasound, a non-invasive test used to assess the blood flow in the arteries. If the duplex shows evidence of blockages, the next step is an angiogram. An angiogram is a procedure during which a small flexible tube, called a catheter, is inserted into the artery. Contrast dye is injected and a series of x-rays is taken to confirm the blockages. Such blockages can either be ballooned open and stented, or sometimes require open surgical repair.
Symptoms of Mesenteric Ischemia
- Abdominal pain
- Dull, crampy pain, located in the upper mid-abdomen
- Onset 15 min after eating (postprandial abdominal pain), lasting several hours
- Predictable and constant pattern
- Food fear – the thought of eating and the pain associated with eating prevents the patient from eating
- Weight loss
- Nausea, vomiting, and diarrhea
