Chronic visceral ischemia: An unusual cause of abdominal pain
Turan Acar1
, Volkan Çakır2, Nihan Acar1, Kemal Atahan1, Mehmet Hacıyanlı1
1Department of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
2Department of Interventional Radiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
Abstract
Chronic visceral ischemia is described as postprandial abdominal pain caused by intestinal hypoperfusion. Chronic visceral ischemia arising from the stenosis of major mesenteric arteries can cause death. Chronic abdominal pain, weight loss, and sitophobia are the major symptoms. The main cause of chronic visceral ischemia is atherosclerosis; Doppler ultrasonography, tomographic angiography, and magnetic resonance angiography can be used for diagnosis. The gold standard method is mesenteric catheterized angiography. Surgical bypass or endovascular balloon angioplasty and stent replacement can also be performed to prevent serious complications and death. A total of three patients, two male and one female, applied to emergency services with blunt abdominal pain lasting a few hours that started after meals and was located in the epigastric and periumblical regions. The patients were diagnosed with chronic visceral ischemia after screening tests and physical examination. Mesenteric catheterized angiography was performed immediately in all the cases. Balloon angioplasty and stent replacement were performed on the stenoses, and occlusions were detected. Mesenteric catheterized angiography may be preferred in cases with strong clinical suspicion; balloon angioplasty and stent replacement can also be used as treatments with lower rates of complications.
Keywords: Chronic mesenteric ischemia, superior mesenteric arteries, balloon angioplasty, stent
Cite this paper as: Acar T, Çakır V, Acar N, Atahan K, Hacıyanlı M. Chronic visceral ischemia: An unusual cause of abdominal pain. Turk J Surg 2018; 34: 158-161.
This study was presented at the 19th National Surgical Congress, 16-20 April 2014, Antalya, Turkey.
Cite this paper as: Acar T, Çakır V, Acar N, Atahan K, Hacıyanlı M. Chronic visceral ischemia: An unusual cause of abdominal pain. Turk J Surg 2018; DOI: 10.5152/turkjsurg.2017.3205
Written informed consent was obtained from patient who participated in this study.
Externallypeer-reviewed.
Concept - T.A., N.A., M.H.; Design - T.A., N.A., M.H.; Supervision - T.A., N.A., K.A.; Resource - T.A., V.C.; Materials - T.A., N.A., K.A.; Data Collection and/or Processing - T.A., N.A., K.A.; Analysis and/or Interpretation - V.C., K.A., M.H.; Literature Search - T.A., N.A.; Writing T.A., N.A. Manuscript - T.A., N.A.; Critical Reviews - K.A., M.H., V.C.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.
The authors would like to thank Department of General Surgery and Gastroenterology staff for their cooperation.