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Critical intestinal ischaemia in a patient with patent mesenteric vasculature

Lookup NU author(s): Dr Sarah Hearnshaw, Dr Richard Jackson, Dr Nicholas Thompson

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Abstract

We present a case of a 62-year-old man with known coeliac disease who was admitted for investigation of abdominal pain and weight loss. He underwent multiple biochemical, haematological, radiological and endoscopic investigations (which were all normal) and also had a normal laparoscopy. Abdominal computerized tomography angiography, however, suggested significant mesenteric stenosis. Mesenteric angiography confirmed superior mesenteric artery stenosis and reproduced the patient's abdominal pain when the catheter crossed the lesion. Balloon angioplasty successfully dilated the stenosis, and since then the patient has gained 19 kg in weight (returning his body mass index from 17 to 23) and has been symptom free. Symptomatic single vessel mesenteric ischaemia (other than coeliac artery stenosis in median arcuate syndrome) is not previously well described. The symptom reproduction on catheterization highlights how useful angiography can be in diagnosis of disease significance. Symptom resolution after angioplasty demonstrated clearly how even single vessel disease can cause significant compromise to the mesenteric circulation. (C) 2004 Lippincott Williams Wilkins.

Publication metadata

Author(s): Hearnshaw SA, Bateson M, Jackson R, Thompson NP

Publication type: Article

Publication status: Published

Journal: European Journal of Gastroenterology and Hepatology

Year: 2004

Volume: 16

Issue: 11

Pages: 1245-1246

ISSN (print): 0954-691X

ISSN (electronic): 1473-5687

Publisher: Lippincott Williams & Wilkins

URL: http://dx.doi.org/10.1097/00042737-200411000-00027

DOI: 10.1097/00042737-200411000-00027

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