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Chronic mesenteric ischaemia

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Chronic mesenteric ischaemia is an uncommon condition caused by gross atherosclerotic narrowing of the main mesenteric arteries. The blood supply to the gut is adequate during rest but inadequate during active digestion.

Patients present with:

  • colicky, epigastric pain occuring 30-60 minutes after eating; may be relieved by defaecation
  • food fear, resulting in weight loss
  • an abdominal bruit

Diagnosis is by angiography which should include a lateral view of the aorta and the origins of the main vessels. An alternative is duplex ultrasound.

Treatment is by surgical reconstruction of one or more of the mesenteric arteries. Three vessel reconstruction provides the best results with a 40% recurrence rate.

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