Abdominal Angina Workup
- Author: Faisal Aziz, MD; Chief Editor: John Geibel, MD, DSc, MSc, MA more...
No laboratory tests are diagnostic. Usually, nutritional parameters are suggestive of malnutrition. If malignancy or gastric ulcer disease is suspected, consider obtaining appropriate laboratory and other diagnostic studies.
Mesenteric angiography is the classic criterion standard diagnostic study. Because the vessels emerge from the anterior wall of the aorta, the ostia are visualized only on a lateral view (see the first image below). A prominent meandering mesenteric artery (see the second image below) is another clue.
Duplex ultrasonography is emerging as a useful screening modality in this setting. It currently is most useful in cases where the diagnosis is suspected.[7, 8]
Indices that are studied include the following:
- Peak systolic flow - This is increased if a stenosis is present
- Normal vasodilatory response in response to eating - This is lost, especially in the superior mesenteric artery (SMA)
Computed tomography angiography (CTA) of the aorta and mesenteric arteries is now considered an alternative to mesenteric angiography by most authorities.
Because most of these patients have generalized vascular disease, it is prudent to carry out a cardiovascular evaluation before performing surgery.
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