K. Hoogenberg et al., CHRONIC MESENTERIC ISCHEMIA - DIAGNOSTIC CHALLENGES AND TREATMENT OPTIONS, Journal of internal medicine, 237(3), 1995, pp. 293-299
Objectives. A description of the clinical presentation, diagnostic pro
cedure and mode of therapy in three patients suffering from chronic me
senteric ischaemia. Design and interventions. In all cases, the diagno
sis was made on the basis of abdominal complaints in combination with
angiographic findings. The primary treatment objective was restoration
of blood flow via a revascularization procedure, for the patient in w
hom this could not be accomplished an enteral feeding programme was un
dertaken. Results. One patient had a panmalabsorption syndrome which w
as treated with an aortomesenteric bypass operation, the second one pr
esented with multiple gastric ulcerations which only improved after a
percutaneous transluminal angioplasty. In the third patient, neither s
urgery or angioplasty were feasible and a tentative enteral feeding pr
ogramme was given, after which the ability to consume a normal oral di
et without abdominal distress was regained. Conclusions. These three c
ases illustrate the diverse clinical pictures by which chronic mesente
ric ischaemia may present itself. This diagnosis should be kept in min
d when other more common causes of a patient's abdominal complaints ca
nnot be found, hence giving consideration to abdominal angiography as
the next diagnostic procedure. With respect to therapy, restoring bloo
d now through surgery or angioplasty is the primary form of treatment.
However, if neither of these therapeutic options is feasible, it is s
uggested that such patients may benefit from a nutritional training pr
ogramme.