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Mesenteric ischaemia--a diagnostic triad?

J A Garisch, I N Marks

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |January 19, 1980
    PubMed
    Summary
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    Chronic mesenteric ischaemia caused severe gastrointestinal symptoms and weight loss in an elderly patient. Autopsy revealed mesenteric vascular disease, highlighting the importance of early diagnosis for this condition.

    Area of Science:

    • Vascular Surgery
    • Gastroenterology
    • Internal Medicine

    Background:

    • Ischaemic heart and peripheral vascular disease are common in the elderly.
    • Chronic mesenteric ischaemia (CMI) can present with vague gastrointestinal symptoms.
    • Early diagnosis of CMI is crucial but often challenging.

    Observation:

    • An elderly male patient with known vascular disease presented with a 3-month history of worsening postprandial epigastric pain, nausea, vomiting, diarrhoea, and weight loss.
    • Gastroscopy revealed superficial antral ulceration and discoloration.
    • The patient's condition rapidly deteriorated, leading to death shortly after hospital admission.

    Findings:

    • Autopsy confirmed mesenteric vascular disease and ischaemic bowel.
    • The findings support a diagnosis of chronic mesenteric ischaemia as the cause of the patient's symptoms and demise.

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  • Superficial gastric ulceration can be a manifestation of visceral ischaemia.

    • Implications:

    • This case underscores the potential severity of chronic mesenteric ischaemia.
    • Arteriography should be considered in patients with unexplained gastrointestinal symptoms and risk factors for vascular disease.
    • Timely diagnosis and intervention in CMI may improve patient outcomes and prevent fatal complications.