Chronic mesenteric ischemia, also known as intestinal angina, is defined by reduced blood flow to major mesenteric arteries (celiac, superior mesenteric, inferior mesenteric) causing abdominal pain which is often postprandial. This can result in food aversion, anorexia, and weight loss.
Chronic mesenteric ischemia is typically caused by atherosclerotic disease. However, vasculitis, aortic or mesenteric artery dissection, fibromuscular dysplasia, celiac artery compression by the median arcuate ligament, retroperitoneal fibrosis, or endovascular graft occlusion should be considered as alternative etiologies.
The same risk factors for peripheral and coronary artery disease predispose to chronic mesenteric ischemia, namely smoking, hypertension, diabetes, and hyperlipidemia.
Related topic: Acute mesenteric ischemia
Chronic mesenteric ischemia
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Synopsis
Codes
ICD10CM:
K55.1 – Chronic vascular disorders of intestine
SNOMEDCT:
111354009 – Chronic vascular insufficiency of intestine
K55.1 – Chronic vascular disorders of intestine
SNOMEDCT:
111354009 – Chronic vascular insufficiency of intestine
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Acute mesenteric ischemia
- Peptic ulcer disease
- Gastroesophageal reflux disease
- Gastritis
- Malignancy
- Pancreatitis
- Choledocholithiasis
- Biliary colic
- Cholecystitis
- Constipation (eg, drug-induced constipation)
- Pancreatic cancer
- Hepatitis
- Pericarditis
- Angina (cardiac) (see acute coronary syndrome, coronary artery disease)
- Achalasia
- Bowel obstruction (see small bowel obstruction, large bowel obstruction)
- Inflammatory bowel disease (see Crohn disease, ulcerative colitis)
- Irritable bowel syndrome
- Celiac disease
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:12/26/2017
Last Updated:09/16/2020
Last Updated:09/16/2020