Chronic Mesenteric Ischemia Clinical Presentation

Updated: Oct 29, 2019
  • Author: Aref Alrayes, MD; Chief Editor: Burt Cagir, MD, FACS  more...
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Presentation

History

Patients with chronic mesenteric ischemia (CMI) typically present with a history of the following [12, 13] :

  • 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

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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)

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