Chronic Mesenteric Ischemia Clinical Presentation

Updated: Dec 29, 2017
  • Author: Aref Alrayes, MD; Chief Editor: Burt Cagir, MD, FACS  more...
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History and Physical Examination


Patients with chronic mesenteric ischemia (CMI) typically present with a history of the following:

  • Postprandial pain, generally epigastric or periumbilical
  • Fear of eating (sitophobia)
  • Weight loss
  • History of vascular disease involving other organs (eg, myocardial infarction [MI], cerebral vascular disease, or peripheral vascular disease)

The classic symptom is postprandial pain developing between 10 minutes and 3 hours after a meal. The pain can become so severe that the patient may develop a fear of eating and report recent weight loss.

Other nonspecific symptoms include the following:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Flatulence

Physical examination

Upon physical examination, the following may be found:

  • Signs of malnutrition
  • Pain that is disproportionate to examination findings: Usually, diffuse mild abdominal tenderness, with no rebound or guarding
  • Abdominal bruit
  • Signs of peripheral vascular disease (eg, carotid bruits, decreased pulses, and ischemic feet)