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Updated: Aug 16, 2026

Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Abdominal angina in patients with a midgut carcinoid, a sign of severe pathology
Harry deVries1, Rob T M Wijffels, Pax H B Willemse
1Department of Surgery, University Medical Center Groningen, 30.001, 9700 RB Groningen, The Netherlands. Vriesdeh@dz.nl
Abstract:
In 36 consecutive patients with a foregut carcinoid with extensive local tumor growth and liver metastases with a carcinoid syndrome, six patients had complaints of postprandial abdominal pain and attacks of subileus based on segmental intestinal ischemia. A diagnosis of abdominal angina was supported by a positive response to nitroglycerin in two and ischemia of the ileum demonstrated by angiography in two other patients. Complaints were reduced in all patients after surgery. Histopathology of the resected small bowel specimens showed elastic vascular sclerosis in three patients and ischemic changes in three other patients, confirming the clinical diagnosis. Resection of ischemic bowel can provide relief in patients with segmental intestinal ischemia caused by carcinoid-induced vascular sclerosis.
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