Abstract
IntroductionAbdominal angina is a descriptive term for abdominal pain that can occur postprandially in patients with occlusive mesenteric vascular disease due to insufficient increase in blood flow.Case presentationIn this case a 60-year-old Caucasian woman with a 2 year history of abdominal angina presented to hospital for elective mesenteric revascularization surgery. Postoperative recovery was complicated by graft occlusion resulting in hepatic ischemia as well as splenic and small bowel infarction.ConclusionThis case highlights the importance of keeping this differential diagnosis in mind when dealing with patients who have a long history of abdominal pain and discusses some of the complications that may occur after surgical treatment.
Highlights
Abdominal angina is a descriptive term for abdominal pain that can occur postprandially in patients with occlusive mesenteric vascular disease due to insufficient increase in blood flow.Case presentation: In this case a 60-year-old Caucasian woman with a 2 year history of abdominal angina presented to hospital for elective mesenteric revascularization surgery
This is a rare case of a patient with abdominal angina secondary to occlusive mesenteric vascular disease
The patient was referred to our hospital for a mesenteric artery angiogram. This demonstrated a high grade stenosis of the proximal coeliac artery, complete occlusion of the superior mesenteric artery and hypertrophy of the inferior mesenteric artery with evidence of a wondering artery of Drummond supplying the branches of the superior mesenteric artery and confirmed the suspected diagnosis of occlusive mesenteric vascular disease
Summary
This is a rare case of a patient with abdominal angina secondary to occlusive mesenteric vascular disease. The patient described the abdominal pain as intermittent, mostly appearing 20 to 30 minutes after eating big meals As a consequence she had begun to associate food with pain and had developed sitophobia (fear of food) resulting in significant weight loss. Cases Journal 2009, 2:82 http://www.casesjournal.com/content/2/1/82 min and oral temperature was 36.7°C Her examination revealed normal jugular venous pressure and normal breath sounds over both lung bases. After routine preparations for surgery the patient went to theatre and mesenteric revascularization was performed with an antegrade prosthetic graft bypass. The day blood tests showed a steep rise in her liver enzymes (ALT 1792 U/L, AST 2731 U/L) suggestive of hepatic ischemia and duplex ultrasonography confirmed the suspected diagnosis of graft occlusion. The recovery period was prolonged but without further complications and the patient was transferred for rehabilitation
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