Chronic mesenteric ischemia: a case report and review of the literature

Abstract

Chronic mesenteric ischemia (CMI) is a rare vascular disease. Unlike acute ischemia with a sudden onset, CMI is characterized by permanent or episodic intestinal hypoperfusion, usually due to atherosclerotic vascular lesion. Despite the high prevalence of atherosclerosis of mesenteric arteries in the general population, clinical manifestations of CMI may be absent up to the end-stage disease, which is due to the formation of extensive collateral circulation and the presence of residual fetal circulation. CMI not only worsens the quality of life, but also increases the risk of acute ischemia against the background of chronic. This problem is relevant, since the incidence and related mortality do not tend to decrease. The article presents the case report of CMI in a patient with an atypical abdominal angina. The etiopathogenesis, clinical picture, diagnosis and treatment methods are described in relation not only to the presented report, but also to literature data. This improves understanding and management strategy of this rare life-threatening pathology.

Keywords

• atherosclerosis
• chronic mesenteric ischemia
• abdominal angina
• inferior mesenteric artery
• endovascular revascularization