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Multimodality Diagnosis of Mesenteric Ischemia
05:07

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

Giant cell arteritis manifesting as mesenteric ischemia

David Clay Evans1, Michael P Murphy, Jeffrey H Lawson

  • 1Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.

Journal of Vascular Surgery
|November 9, 2005
PubMed

Insights

Giant cell arteritis can cause chronic mesenteric ischemia, a rare condition leading to vascular insufficiency. Early diagnosis and glucocorticoid therapy are crucial to prevent severe outcomes, especially before surgical intervention.

Area of Science:

  • Vascular Surgery
  • Rheumatology
  • Internal Medicine

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting medium and large arteries.
  • It can manifest with diverse clinical presentations, including abdominal symptoms like chronic mesenteric ischemia.
  • Vascular insufficiency due to GCA is often underdiagnosed, potentially leading to adverse outcomes.

Observation:

  • An 80-year-old woman presented with chronic mesenteric ischemia.
  • Imaging studies revealed stenosis in the superior mesenteric artery and celiac artery.
  • Elevated erythrocyte sedimentation rate and a positive temporal artery biopsy confirmed GCA.

Findings:

  • Giant cell arteritis was diagnosed as the cause of chronic mesenteric ischemia.
  • Glucocorticoid therapy was initiated, indicating a medical management approach.
  • The case highlights the importance of considering GCA in patients with unexplained mesenteric vascular disease.

Implications:

  • Early recognition of giant cell arteritis is vital to avoid misdiagnosis and inappropriate surgical interventions.
  • Prompt glucocorticoid treatment can mitigate the risk of severe vascular complications.
  • This case underscores the need for a multidisciplinary approach in managing complex vascular conditions.

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