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Abdominal Angina


Presentation

  • Two cases of verified abdominal angina are presented. Multiple, atypical ulcerations in the postbulbar duodenum were diagnosed endoscopically in both cases. Atypical gastric ulcers were also present in one case.[ncbi.nlm.nih.gov]
  • The purpose of this review is to discuss the pathophysiology and clinical presentation of chronic mesenteric ischemia and to suggest a diagnostic flowchart for this complex condition.[ncbi.nlm.nih.gov]
  • The limited experience in the active management of this, potentially lethal, condition prompted us to present the case of a 54 year old man with an exceedingly rare etiology of mesenteric ischemia.[ncbi.nlm.nih.gov]
  • The authors hereby present a case of TA that presented with abdominal aorta thrombosis.[casereports.bmj.com]
  • VL - 32 IS - 9 N2 - A 5-year-old boy presented with episodic, postprandial abdominal pain and hypertension.[unboundmedicine.com]
Weight Loss
  • Abdominal angina is an underrecognized cause of postprandial abdominal pain and weight loss.[ncbi.nlm.nih.gov]
  • Abstract A young man with severe abdominal pain and weight loss due to intestinal ischemia was examined. At operation, the origins of the celiac and superior mesenteric arteries were found to be compressed by plexiform neurofibromatosis.[ncbi.nlm.nih.gov]
  • The pain was chronic, of pressure-like quality, constant but worsened by exertion and mostly by eating resulting in significant unintentional weight loss. A work-up for myocardial infarction, pulmonary embolism and peptic ulcer disease was negative.[shmabstracts.com]
  • Outstanding symptoms include postprandial pain, weight loss, and constipation. Gastrointestinal studies may be negative or may show evidence of impaired intestinal motility, excessive fat in the feces, and occult blood.[jamanetwork.com]
  • The classic triad of abdominal pain, weight loss, and diarrhea produces fear of eating. Most laboratory and radiologic investigations are inconclusive.[ncbi.nlm.nih.gov]
Coronary Artery Disease
  • artery disease or the intermittent claudication that accompanies peripheral vascular disease.[emedicine.medscape.com]
  • The surgical procedures in the treatment of abdominal angina are not significantly different from that for coronary artery disease (CAD) and a myocardial infarction (heart attack). There are basically three options : Widening the narrowed artery.[healthhype.com]
  • In addition other signs of peripheral vascular disease like calf claudications, coronary artery disease, etc may also be present.[tandurust.com]
  • The abdominal pain is a consequence of blood flow not being able to meet visceral demand and is therefore thought to be similar to angina pectoris in patients with coronary artery disease or claudication in peripheral vascular diesease.[casesjournal.biomedcentral.com]
Abdominal Pain
  • The patient was relieved of abdominal pain immediately after the dilatation.[ncbi.nlm.nih.gov]
  • Abdominal angina refers to abdominal pain in which perfusion to digestive tissues has been compromised, usually due to mesenteric atherosclerosis. Pathology can progress to necrosis of vital viscera, sepsis, or even death.[ncbi.nlm.nih.gov]
  • Abdominal angina is an underrecognized cause of postprandial abdominal pain and weight loss.[ncbi.nlm.nih.gov]
  • The classic triad of celiac compression syndrome consists of abdominal pain, an epigastric bruit, and angiographic evidence of celiac compression.[ncbi.nlm.nih.gov]
  • In 36 consecutive patients with a foregut carcinoid with extensive local tumor growth and liver metastases with a carcinoid syndrome, six patients had complaints of postprandial abdominal pain and attacks of subileus based on segmental intestinal ischemia[ncbi.nlm.nih.gov]
Constipation
  • Outstanding symptoms include postprandial pain, weight loss, and constipation. Gastrointestinal studies may be negative or may show evidence of impaired intestinal motility, excessive fat in the feces, and occult blood.[jamanetwork.com]
  • Accompanying anxiety symptoms: • Temperature • Leukocytosis – increase of leukocytes in the blood • Nausea and vomiting • Constipation and lack of gas • Peritonizam – hardening of the abdominal wall • haematemesis (vomiting blood) and melena (blood in[myhealth-guide.org]
  • Patient may be constipated or may have diarrhea. The pain may continue for many hours as the digestive system is exerted, due to decreased blood supply, in order to digest the food. Upon palpation, the abdomen often feels hollow and soft.[epainassist.com]
  • Other symptoms Nausea Vomiting Bloating Constipation or diarrhea Weight loss Abdominal angina diagnosis The symptoms, particularly the location, duration and nature of the pain after eating, along with the patient’s medical history may raise the suspicion[healthhype.com]
Severe Abdominal Pain
  • Abstract A young man with severe abdominal pain and weight loss due to intestinal ischemia was examined. At operation, the origins of the celiac and superior mesenteric arteries were found to be compressed by plexiform neurofibromatosis.[ncbi.nlm.nih.gov]
  • The patient usually complains of severe abdominal pain that starts after eating a meal. In most cases, the pain gradually subsides after a few hours. Because the pain is so severe, most people develop a fear of eating and hence lose weight.[ncbi.nlm.nih.gov]
  • Acute Mesenteric Ischemia often presents with sudden and severe abdominal pain .[diagnose-me.com]
  • Symptoms Early signs and symptoms of acute mesenteric ischemia include: Severe abdominal pain, concentrated in one area of the abdomen Nausea and/or vomiting Bloody stools History of chronic atrial fibrillation or cardiovascular disease Diagnosis An arteriogram[my.clevelandclinic.org]
Abdominal Bruit
  • An abdominal bruit may be heard in some patients. One may also find features of peripheral vascular disease with diminished pulses in the leg. The digital rectal exam is usually guaiac negative.[ncbi.nlm.nih.gov]
  • The abdomen is scaphoid and soft and abdominal bruit is present in almost 80% of the patients. In addition other signs of peripheral vascular disease like calf claudications, coronary artery disease, etc may also be present.[tandurust.com]
  • Signs Abdominal bruit (60-90%) Fecal Occult Blood Test ing (10%) VI. Imaging: Diagnosis Angiography (gold standard) MRA Abdomen Ultrasound duplex VII. Management Vascular Surgery Endovascular procedures VIII.[fpnotebook.com]
  • Abdominal bruits are present in 60% to 80% of patients with AA. 3 Also, patients will often show classic signs of PVD, as this is a frequent comorbidity of AA.[journals.lww.com]
  • Examination may show vague abdominal tenderness disproportionate to the severity of the pain, an abdominal bruit and signs of generalised cardiovascular disease.[patient.info]
Acute Abdomen
  • A few days after the onset of symptoms, the pain became more severe, and progressed into a picture of acute abdomen and intestinal obstruction. Urgent laparotomy findings showed the presence of small bowel gangrene.[unboundmedicine.com]
  • Presentation [ 10 ] The condition may be difficult to diagnose, with nonspecific symptoms of an 'acute abdomen', such as acute-onset abdominal pain. The pain is most frequently located in the left iliac fossa.[patient.info]
  • Mesenteric ischemia has an annual incidence of 0.09% to 0.2% per patient year , although this may be underreported. 1 Approximately 1% of acute abdomen hospitalizations are the result of mesenteric ischemia and it occurs in one in 1,000 patients presenting[emdocs.net]
  • Later, features of an acute abdomen with tenderness and guarding, and leucocytosis may appear. This is differentiated from arterial occlusion by one of the associated diseases that is commonly present.[surgwiki.com]
  • Abdominal involvement was the cause of death in 4 (4.9%) patients (3 patients with liver failure and 1 patient with acute abdomen) [ 124 , 125 ].[academic.oup.com]
Vascular Disease
  • To conclude, this is a rare case of abdominal angina due to occlusive mesenteric vascular disease.[casesjournal.biomedcentral.com]
  • The most common cause of abdominal angina is atherosclerotic vascular disease, where the occlusive process commonly involves the ostia and the proximal few centimeters of the mesenteric vessels.[parasitetesting.com]
  • The most common cause of abdominal angina is atherosclerotic vascular disease.[emedicine.medscape.com]
Dry Eyes
  • Brand-new chapters cover Ebola , Chikungunya , dry eye , and adolescent health. In addition to current therapy, each chapter also features important diagnostic criteria to ensure delivery of the correct diagnosis and treatment.[books.google.ro]

Workup

  • Hepatitis can be checked initially with a liver function workup. Most likely, an abdominal abscess or appendicitis would be detected during a thorough physical examination and history.[journals.lww.com]
  • The authors advised careful screening for aPL in the pre-transplant workup.[academic.oup.com]

Treatment

  • The surgical treatment led to complete resolution of his symptoms.[ncbi.nlm.nih.gov]
  • Intraluminal stenting for treatment of mesenteric ischemia represents a viable alternative to surgical revascularization in selected cases.[ncbi.nlm.nih.gov]
  • Nevertheless, multi-detector row CT angiography with appropriate postprocessing techniques is highly effective for the diagnosis, evaluation, and treatment of suspected AA.[ncbi.nlm.nih.gov]
  • 32 Neurological Monitoring with Evoked Potentials 401 33 Spinal Cord Ischemia 413 34 Endovascular Treatment of ThoracoAbdominal Aortic Aneurysm with Branched Endografts The NürnbergCleveland Experience 425 35 Endovascular Treatment of ThoracoAbdominal[books.google.ro]
  • The conventional treatment consists of vessels revascularization, but sometimes this is not applicable.[ncbi.nlm.nih.gov]

Prognosis

  • The good longterm results after arterial reconstruction in contrast to the poor prognosis without operation call for early diagnosis and surgical treatment.[ncbi.nlm.nih.gov]
  • Prognosis Surgical management is the criterion standard for treatment of this disease. [3] Despite advances in surgery, the mortality associated with acute mesenteric ischemia is in the range of 60-95%.[emedicine.medscape.com]
  • Prognosis Surgical management is the standard for treatment of this disease. The mortality is still in the range of 60-95%.[ncbi.nlm.nih.gov]
  • Prognosis In cases of mesenteric artery ischemia , prognosis is especially poor if the patient is not treated quickly. Even with treatment the risk of death is 30-90%, depending on the stage at which treatment is started.[diagnose-me.com]

Etiology

  • The limited experience in the active management of this, potentially lethal, condition prompted us to present the case of a 54 year old man with an exceedingly rare etiology of mesenteric ischemia.[ncbi.nlm.nih.gov]
  • Median arcuate ligament syndrome (see Pathophysiology and Etiology ) has been reported in young individuals.[emedicine.medscape.com]
  • The etiology and pathogenesis of vascular disorders of the intestine. Radiol Clin North Am . 2008;46(5):877–885. Keywords: intestinal ischemia ; mesenteric atherosclerosis ; mesenteric ischemia 2010 Lippincott Williams & Wilkins, Inc.[journals.lww.com]
  • Etiology Ischemia of the intestine results from an imbalance of oxygen supply to and oxygen consumption by the GI tract. A decrease in blood flow results from decreased size of mesenteric vessels.[ncbi.nlm.nih.gov]

Epidemiology

  • The etiology includes the following: Atherosclerosis Smoking Epidemiology The syndrome is extremely rare, and the true incidence is unknown. The mean age of affected individuals is slightly older than 60 years.[emedicine.medscape.com]
  • Epidemiology Abdominal angina is rare and has a high mortality rate. It is more common in females and the elderly. The problem with diagnosis is that the symptoms are often vague and no work up is ever done.[ncbi.nlm.nih.gov]
  • EPIDEMIOLOGY While several vasculitides may be associated with gastrointestinal involvement, it is most prevalent in patients with immunoglobulin A vasculitis (Henoch-Schönlein purpura), antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis[uptodate.com]
  • He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education.[lifeinthefastlane.com]
Sex distribution
Age distribution

Pathophysiology

  • The purpose of this review is to discuss the pathophysiology and clinical presentation of chronic mesenteric ischemia and to suggest a diagnostic flowchart for this complex condition.[ncbi.nlm.nih.gov]
  • PATHOPHYSIOLOGY The pathophysiology is similar to that seen in angina pectoris and intermittent claudication.[parasitetesting.com]
  • Pathophysiology The pathophysiology is similar to that seen in angina pectoris and intermittent claudication .[ipfs.io]
  • Pathophysiology [ edit ] The pathophysiology is similar to that seen in angina pectoris and intermittent claudication .[en.wikipedia.org]

Prevention

  • Abdominal angina is an early clinical expression of occlusive mesenteric arterial insufficiency, a condition that requires aggressive treatment to prevent intestinal infarction.[ncbi.nlm.nih.gov]
  • If the cause is colonic ischemia, antibiotics are given to control or prevent infections that have resulted from abdominal angina.[epainassist.com]
  • […] and Treatment of Renal Insufficiency 219 19 Prevention and Treatment of Respiratory Insufficiency 229 20 Anesthetic Management of Open ThoracoAbdominal Aortic Procedures The Texas Heart Institute Experience 243 21 Anesthetic Management of ThoracoAbdominal[books.google.ro]
  • Revascularization of the celiac and superior mesenteric arteries by arterial reconstructive procedures is important not only to alleviate symptoms but to prevent mesenteric thrombosis and death.[jamanetwork.com]
  • Unstable angina If you have unstable angina (where symptoms develop unpredictably), you'll need medicines to prevent blood clots and reduce your risk of having a heart attack or stroke.[nhs.uk]

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