Multimedia
 | Media file 1: The superior mesenteric artery and inferior mesenteric artery share collateral circulation near the splenic flexure of the colon (shown in red). When dilated, this vessel is termed the meandering mesenteric artery (see Media file 4). As seen on an angiogram, this is a sign of chronic mesenteric ischemia. |
 | Media file 2: The pancreaticoduodenal arcades (shown in red) are collateral pathways between the celiac artery and the superior mesenteric artery. |
 | Media file 3: A lateral aortogram shows abrupt cutoffs at the origin of the visceral vessels and a tapered occlusion of the distal aorta. Because these vessels originate from the anterior surface of the aorta, stenoses and occlusions are not observed clearly on standard anteroposterior views. |
 | Media file 4: This arteriogram illustrates a meandering mesenteric artery. This dilated tortuous vessel corresponds to the small collateral near the splenic flexure seen in Media file 1. The appearance of a meandering mesenteric artery such as this one supports the diagnosis of chronic mesenteric ischemia. |
 | Media file 5: This operative photograph shows a completed retrograde bypass to the superior mesenteric artery using ePTFE graft material. Photograph courtesy of Jamal Hoballah, MD, University of Iowa College of Medicine. |
 | Media file 6: The celiac artery is exposed at its origin in preparation for antegrade bypass. |
 | Media file 7: The superior mesenteric artery and several branches are exposed for antegrade bypass. |
 | Media file 8: This photo shows an antegrade bypass from the aorta to the superior mesenteric artery and the celiac artery (superior mesenteric artery anastomosis is shown) using a Dacron graft. |
 | Media file 9: This diagram shows the possible incision for a trapdoor aortotomy. Plaque at the orifices of the visceral vessels is removed after the trapdoor incision is lifted. When a satisfactory endarterectomy has been achieved, the trapdoor is sutured shut. |
 | Media file 10: This completion duplex ultrasound study shows excellent flow at the distal anastomosis. |
 | Media file 11: Upper gastrointestinal series (barium swallow) shows an ulcer. |
More on Abdominal Angina |
| Overview: Abdominal Angina |
| Differential Diagnoses & Workup: Abdominal Angina |
| Treatment & Medication: Abdominal Angina |
| Follow-up: Abdominal Angina |
 Multimedia: Abdominal Angina |
| References |
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Further Reading
Keywords
intestinal angina, chronic mesenteric ischemia, abdominal angina, postprandial abdominal angina, occlusive mesenteric vascular disease, postprandial pain, symptomatic occlusive mesenteric ischemia, central abdominal pain
