Abdominal Angina

 

Abdominal Angina

Kunal Mahajan; Azeberoje Osueni; Muhammad Haseeb.

Abdominal angina is postprandial pain that occurs in mesenteric vascular occlusive disease when blood flow to the colon is unable to meet visceral demands. This is similar to intermittent claudication in peripheral vascular disease or angina pectoris in coronary artery disease. 

Atherosclerotic disease is the most common cause of abdominal angina.  In most people, it is occlusion of the superior mesenteric artery that is responsible for the abdominal symptoms.

Shortly after eating, patients with abdominal angina are unable to increase flow in the mesenteric vessels, and they develop pain.

Author Information

Last Update: May 23, 2022.

https://www.ncbi.nlm.nih.gov/books/NBK441943/

Mesenteric artery disease

https://academic.oup.com/eurheartj/article/39/9/763/4095038

https://www.bcm.edu/healthcare/specialties/cardiovascular-medicine/vascular-health/mesenteric-artery-disease

Mesenteric artery stenosis

Debabrata Mukherjee and Leslie Cho.

https://www.ncbi.nlm.nih.gov/books/NBK27423/

Chronic Mesenteric Ischemia: Diagnosis and Treatment

Eric J. Hohenwalter, M.D.1

Semin Intervent Radiol. 2009 Dec; 26(4): 345–351.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036470/

Mesenteric Artery Ischemia

Alin Gragossian; Maxim E. Shaydakov; Patrick Dacquel.

Author Information

Last Update: May 9, 2022.

https://www.ncbi.nlm.nih.gov/books/NBK513354/

Chronic Mesenteric Ischemia

Ronak Patel; Abdul Waheed; Michael Costanza.

Author Information

Last Update: July 12, 2022.

Mesenteric ischemia is a manifestation of peripheral vascular disease in which the blood supply fails to meet the metabolic demands of visceral organs.

Mesenteric artery stenosis is relatively common, occurring in up to 10% of the population over 65 years of age. However, CMI has a very low incidence, accounting for less than 1 in 1000 hospital admissions for abdominal pain. Patients are typically between the ages of 50 and 70 years of age, with a strong female predominance, and have other coexisting manifestations of atherosclerotic disease.

Indications for Surgery

Signs of peritonitis on physical exam

Massive lower GI hemorrhage

Ongoing signs of abdominal pain, fever, or  sepsis

Symptoms that have persisted for more than 14 to 21 days

Chronic malabsorption leading to protein-losing colopathy

Colonoscopic evidence of segmental colitis with frank ulceration

Presence of an ischemic stricture and abdominal symptoms

https://www.ncbi.nlm.nih.gov/books/NBK430748/