Chronic small intestinal ischaemia

Chronic small intestinal ischaemia

Chronic small intestinal ischaemia almost invariably results from atherosclerosis and a ff ects the proximal superior mesen teric and coeliac vessels. Patients classically present with symptoms of severe central abdominal pain that comes on within 30–60 minutes of eating (mesenteric angina). Weight loss and diarrhoea due to malabsorption may also occur. The condition may be di ffi cult to diagnose and is often overlooked. The presence of significant vascular disease on CT is common in elderly patients and in those with severe vascular disease and should not necessarily be assumed to indicate that abdominal symptoms are attributable to chronic ischaemia. Treatment is usually by selective visceral angiography , with stenting/angio plasty and, where this is not possible, bypass surgery . Smoking cessation is imperative and patients are usually anticoagulated.