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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Hidden in Plain Pain: Diagnosing Ischemic Enteritis Through Surgical Intervention
Aya Obata1,2, Takaaki Kobayashi3, Rui Ouchi1
1Department of General Internal Medicine Kameda Medical Center Kamogawa Chiba Japan.
Clinical Case Reports
|June 19, 2026
Summary
A rare cause of chronic abdominal pain in an elderly woman was identified as ischemic enteritis. This condition, characterized by ileal edema, requires surgical confirmation and highlights the importance of considering vascular issues in abdominal pain.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Abdominal Imaging
Background:
- Chronic abdominal pain is a common complaint in the elderly.
- Vascular risk factors can predispose individuals to mesenteric ischemia.
- Ileal edema with a target sign on CT can indicate various intestinal pathologies.
Purpose of the Study:
- To present a case of ischemic enteritis presenting as chronic postprandial abdominal pain.
- To discuss the diagnostic challenges and imaging findings associated with this rare condition.
- To emphasize the importance of considering ischemic enteritis in elderly patients with vascular risk factors and abdominal pain.
Main Methods:
- Case report of an elderly female patient with vascular risk factors.
- Clinical presentation of postprandial abdominal pain.
- Computed Tomography (CT) imaging findings including ileal edema and target sign.
- Confirmation of diagnosis via surgical resection.
Main Results:
- CT scan revealed ileal edema and the characteristic target sign.
- No evidence of vascular occlusion was detected on initial imaging.
- Surgical resection confirmed the diagnosis of ischemic enteritis.
- The patient experienced chronic abdominal pain attributed to this condition.
Conclusions:
- Ischemic enteritis is a rare but significant cause of chronic abdominal pain in elderly patients with vascular risk factors.
- The target sign on CT can be indicative of ischemic enteritis, even without overt vascular occlusion.
- Early recognition and surgical intervention are crucial for managing this condition.
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