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Updated: Aug 2, 2025

Multimodality Diagnosis of Mesenteric Ischemia
05:07

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

662

Reversible 'Unstable' Abdominal Angina Caused by Ruptured Plaque of the Superior Mesenteric Artery: Clinical and

Shaul Yaari1, Nurith Hiller2, Yacov Samet3

  • 1Department of Medicine, Hadassah Hebrew University Hospital, Mount Scopus, Jerusalem, Israel.

European Journal of Case Reports in Internal Medicine
|April 13, 2023
PubMed

Insights

Ruptured atheromatous plaque in mesenteric vessels can cause unstable abdominal angina, similar to unstable angina pectoris. This condition is reversible with antiplatelet medications and statins, and abdominal bruit is a key diagnostic indicator.

Area of Science:

  • Vascular Medicine
  • Gastroenterology
  • Cardiology

Background:

  • Unstable angina is linked to coronary artery disease and ruptured atheromatous plaques.
  • Abdominal angina typically indicates chronic mesenteric ischemia from stable plaques.
  • Ruptured atheromatous plaques are a less common cause of acute abdominal symptoms.

Purpose of the Study:

  • To report the first case of unstable abdominal angina caused by a ruptured atheromatous plaque.
  • To highlight the diagnostic value of epigastric bruit.
  • To demonstrate the efficacy of conservative treatment.

Main Methods:

  • Case report of a patient with new-onset abdominal pain.
  • Diagnosis based on physical examination (epigastric bruit) and imaging (stenosis due to non-calcified atheroma).
  • Treatment with aspirin and statins.

Main Results:

  • A ruptured atheromatous plaque at the superior mesenteric root was identified as the cause of symptoms.
  • Symptoms and epigastric bruit resolved within 3 weeks.
  • Imaging showed regression of the stenotic lesion.

Conclusions:

  • Ruptured atheromatous plaque in mesenteric vessels can mimic unstable angina pectoris, presenting as new-onset abdominal angina.
  • This condition is potentially reversible with antiplatelet therapy and statins.
  • Abdominal bruit is a valuable sign in diagnosing unexplained abdominal pain.

Keywords:
Mesenteric ischemiaabdominal anginaatheromatous plaqueatherosclerosissuperior mesenteric arteryunstable angina

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