Chronic Mesenteric Ischemia, More Attention Is Needed in Cases with Prolonged Abdominal Pain: A Case Report and Brief Review

Abstract

Introduction: Symptomatic chronic mesenteric ischemia (CMI) is a rare condition that usually occurs due to mesenteric artery stenosis (MAS) with a common incidence. Although the prevalence of symptomatic CMI is less than 2%, MAS is more common in the elderly. Case Presentation: A 60-year-old woman with prolonged eating-related abdominal pain and weight loss treated as cholelithiasis by endoscopic retrograde cholangiography was readmitted by recurrent epigastric pain. At this time, she was reevaluated by computed tomography angiography (CTA), and CMI was confirmed. She was treated with percutaneous mesenteric artery stenting and was discharged without pain. There were no complications or pain after 3 months of follow-up. Conclusions: The most prevalent causes of CMI are atherosclerotic processes, such as hypertension, hyperlipidemia, overweight, metabolic syndrome, and smoking. The diagnosis of CMI is confirmed by CTA. Recently, endovascular treatment by percutaneous mesenteric artery stenting is more common than the surgical approaches because of lower in- and out-hospital complications.