Chronic Mesenteric Ischemia

Wilkins, Lippincott Williams; Stone, James L.

doi:10.1053/j.tvir.2014.12.005

Cited by 12 publications

(7 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Chronic mesenteric ischemia, also termed "intestinal angina," results from chronic stenosis or occlusion of one or more of the celiac axis, SMA, or IMA (3). Chronic mesenteric ischemia is almost always secondary to atherosclerosis; less common causes include fibromuscular dysplasia, vasculitides such as Buerger disease and Takayasu arteritis, and postsurgical intimal hyperplasia (8,9). Patients usually present during the sixth decade of life, and a majority of them are former or current smokers (4).…”

Section: Chronic Mesenteric Ischemiamentioning

confidence: 99%

“…Patients with chronic mesenteric ischemia present with different symptoms, such as postprandial dull abdominal cramps that last for 1-2 hours (8). The pain arises from insufficient blood supply to meet the increased demands of digestion (9). Patients may present with an aversion to food, early satiety, unintentional weight loss, nausea, vomiting, and diarrhea (9,10).…”

Section: Introductionmentioning

confidence: 99%

“…The pain arises from insufficient blood supply to meet the increased demands of digestion (9). Patients may present with an aversion to food, early satiety, unintentional weight loss, nausea, vomiting, and diarrhea (9,10).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pearls, Pitfalls, and Conditions that Mimic Mesenteric Ischemia at CT

Fitzpatrick¹,

Rivers-Bowerman²,

Thipphavong³

et al. 2020

RadioGraphics

View full text Add to dashboard Cite

Acute mesenteric ischemia (AMI) is a life-threatening condition with a high mortality rate. The diagnosis of AMI is challenging because patient symptoms and laboratory test results are often nonspecific. A high degree of clinical and radiologic suspicion is required for accurate and timely diagnosis. CT angiography of the abdomen and pelvis is the first-line imaging test for suspected AMI and should be expedited. A systematic "inside-out" approach to interpreting CT angiographic images, beginning with the bowel lumen and proceeding outward to the bowel wall, mesentery, vasculature, and extraintestinal viscera, provides radiologists with a practical framework to improve detection and synthesis of imaging findings. The subtypes of AMI are arterial and venoocclusive disease, nonocclusive ischemia, and strangulating bowel obstruction; each may demonstrate specific imaging findings. Chronic mesenteric ischemia is more insidious at onset and almost always secondary to atherosclerosis. Potential pitfalls in the diagnosis of AMI include mistaking pneumatosis as a sign that is specific for AMI and not an imaging finding, misinterpretation of adynamic ileus as a benign finding, and pseudopneumatosis. Several enterocolitides can mimic AMI at CT angiography, such as inflammatory bowel disease, infections, angioedema, and radiation-induced enterocolitis. Awareness of pitfalls, conditions that mimic AMI, and potential distinguishing clinical and imaging features can assist radiologists in making an early and accurate diagnosis of AMI. © RSNA, 2020 • radiographics.rsna.org

show abstract

Section: Chronic Mesenteric Ischemiamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pearls, Pitfalls, and Conditions that Mimic Mesenteric Ischemia at CT

Fitzpatrick¹,

Rivers-Bowerman²,

Thipphavong³

et al. 2020

RadioGraphics

View full text Add to dashboard Cite

show abstract

“…Surveillance duplex studies at least every 6 months in the first year followed by annual duplex studies are recommended to assess for restenosis. 29,45 A dual anti-platelet regimen with aspirin and clopidogrel for 3 to 12 months following stent placement may improve stent patency. 19…”

Section: Clinical and Imaging Follow-upmentioning

confidence: 99%

Chronic Mesenteric Ischemia: Clinical Diagnosis, Imaging Characteristics, and Endovascular Management

2018

View full text Add to dashboard Cite

Chronic mesenteric ischemia (CMI) is a complex disorder, which typically affects elderly patients who classically present with longstanding abdominal pain and nonspecific clinical symptoms, such as food aversion and weight loss. The disease progression is often gradual due to a rich collateral network, and symptoms are generally not clinically apparent until two or more primary visceral arteries are affected. Symptomatic stenosis or occlusion of the mesenteric arteries can be the result of multiple etiologies, although atherosclerosis is the most common. Given its low incidence, a high clinical suspicion is necessary for diagnosis and to prevent a delay in treatment. Multiple imaging modalities are utilized to confirm the presence of mesenteric vessel involvement and to guide treatment. While open surgical revascularization was once the definitive treatment, endovascular management has become the first-line treatment for atherosclerotic CMI. The endovascular approach with stent placement has shown excellent primary success and encouraging long-term outcomes with reduction in morbidity and mortality compared with open surgical revascularization. Although controversial, median arcuate ligament syndrome (MALS) is a less common cause of CMI, which can affect a more varied patient population. Clinical approach, imaging characteristics, and treatment for this syndrome will also be discussed.

show abstract

“…If left untreated, 43% of symptomatic CMIs can lead to potential fatal malnutrition or to AMI with bowel infarction. 4,5 Consequently, revascularization is imperative.…”

Section: Introductionmentioning

confidence: 99%