Chronic Mesenteric Ischaemia

Chronic atherosclerotic disease of the vessels supplying the intestine

Aetiology

  • Patients are typically female and between 50 and 70 years of age
  • Usually have other coexisting manifestations of atherosclerotic disease

Clinical presentation

  • Moderate-to-severe colicky or constant and poorly localised pain
  • Weight loss, postprandial pain and a fear of eating
  • Other nonspecific symptoms may include nausea, vomiting, or bowel irregularity

Investigations

  • Arteriography is the gold standard investigation to show the site of arterial blockage or stenosis

Management

  • Asymptomatic patients are managed conservatively, with smoking cessation and antiplatelet therapy
  • Symptomatic chronic mesenteric ischaemia is an indication for either open or endovascular revascularisation