Splanchnic blood flow determination in patients with suspected chronic intestinal ischaemia

Chronic intestinal ischaemia is characterized by postprandial abdominal pain and prominent weight loss, often leading to the first clinical suspicion of malignancy. After ruling out various gastrointestinal disorders, chronic intestinal ischaemia should be considered as a potential diagnosis. Besides the clinical picture, various non-invasive procedures are helpful in establishing the diagnosis. Whereas a plain abdominal radiography may show arterial calcifications, duplex ultrasonography is nowadays the leading diagnostic procedure for ruling out significant disease. Another promising and increasingly used technology is magnetic resonance angiography. Suspicious findings must be followed by the gold standard in diagnosis, namely splanchnic angiography. Since all these technologies provide only anatomical evidence of disease, functional imaging techniques assessing splanchnic blood flow after meal challenge using the invasive indocyanine green method may be helpful. However, further studies are needed in the use of this experimental technique in the workup of these patients.