Abdominal angina. Results of arterial reconstruction in 12 patients

Twelve patients suffering from abdominal angina have been operated upon with revascularization of the superior mesenteric artery. Preoperatively, all had the classical symptoms: postprandial pain, wieght loss and abnormalities of the stools. The surgical procedure of choice was endarterectomy with patch grafting; in two cases a vein by-pass have been used. In general, it will be sufficient to reconstruct one artery, even with two or three of the mesenteric arteries afflicted. Peroperative measurements of pressure gradients and flow may guide in choice of procedure. Two patients died postoperatively, both had additional extensive reconstruction of the aorta and the renal arteries. The remaining 10 patients were all relieved of their symptoms after the operation and gained considerably in weight. They were followed over 25 months in mean. During the period of observation 2 patients have died from other diseases. The good longterm results after arterial reconstruction in contrast to the poor prognosis without operation call for early diagnosis and surgical treatment. The difficulties involved with the diagnosis of abdominal angina are discussed and a functional diagnostic test is proposed.