[Intestinal ischemia. Clinical picture and examination methods]

A review of chronic intestinal ischaemia with special emphasis on symptoms, clinical findings, diagnostic procedures and treatment is given. Chronic intestinal ischaemia is not a frequent disease and is often caused by arteriosclerosis. The symptoms are postprandial abdominal pain accompanied by weight loss. The weight loss is mainly caused by reduced food consumption. The diagnosis is traditionally based on angiography and it is recognised that two of the three arteries to the intestines must be affected before the symptoms are experienced. Recently, more functional tests have become available. Especially the measurements of splanchnic blood flow before and after a test meal are used. The lack of a postprandial rise in blood flow is taken as evidence for intestinal ischaemia. Noninvasive methods such as duplex scanning with measurement of portal flow and tonometry seem promising. The treatment is surgical reconstruction of the blood flow or, more recently, percutaneous transluminal angioplasty. The results are generally excellent, although percutaneous transluminal angioplasty in some cases needs to be repeated. The diagnosis and treatment are for a specialist with a special interest. The patients should be concentrated in just a few centres.