Chronic mesenteric ischemia: Diagnosis and management.

Area of Science:

• Vascular Surgery
• Gastroenterology
• Diagnostic Imaging

Background:

• Chronic mesenteric ischemia (CMI) is an uncommon condition, frequently underdiagnosed.
• Atherosclerosis is the primary cause of CMI.
• Mesenteric artery stenoses (MAS) are common, but collateral circulation often prevents ischemia.

Purpose of the Study:

• To summarize the clinical presentation, diagnosis, and management of CMI.
• To highlight the role of atherosclerosis in CMI.
• To emphasize current diagnostic and therapeutic standards for MAS.

Main Methods:

• Clinical diagnosis based on symptoms and anatomical findings.
• Diagnostic modalities include duplex ultrasound, CT angiography (CTA), and MR angiography.
• High-resolution CTA is the preferred imaging technique for MAS.

Main Results:

• Typical CMI symptoms include postprandial abdominal pain, weight loss, and food avoidance.
• Endovascular therapy using balloon-expandable stents is the preferred treatment for MAS.
• Prompt diagnosis and intervention are crucial for managing CMI.

Conclusions:

• CMI is a clinical diagnosis supported by imaging findings.
• Atherosclerotic MAS is the main etiology, managed effectively with endovascular stenting.
• Awareness and timely diagnosis are key to improving outcomes for CMI patients.