Chronic mesenteric ischemia: diagnosis and treatment

Area of Science:

• Vascular Surgery
• Gastroenterology
• Diagnostic Imaging

Background:

• Chronic mesenteric ischemia (CMI) is a rare condition causing postprandial abdominal pain.
• Atherosclerosis is the most frequent cause of CMI.
• Significant clinical consequences necessitate timely intervention.

Purpose of the Study:

• To highlight the diagnostic challenges and clinical significance of CMI.
• To outline the diagnostic criteria and imaging modalities for CMI.
• To review treatment options for CMI.

Main Methods:

• Review of clinical presentation and diagnostic workup for CMI.
• Emphasis on the role of imaging in identifying mesenteric vessel stenosis or occlusion.
• Discussion of treatment strategies, including open and endovascular revascularization.

Main Results:

• CMI diagnosis requires a high index of suspicion due to slow progression and collateralization.
• Symptoms often manifest when at least two major visceral vessels are affected.
• Treatment is essential to prevent progression to bowel ischemia and infarction.

Conclusions:

• Prompt diagnosis and intervention are vital for managing CMI.
• Both open surgical and endovascular revascularization are effective treatment options.
• Understanding CMI pathophysiology aids in timely and appropriate patient management.