Although the most common manifestation of intestinal ischemia is an acute abdminal catastrophe in an age patient with arterial emboli or cardiogenic shock, chronic intestinal ischemia may produce a lingering nutrional invalidism despite repeated
study
and even exploratory operation. Its incidence was rare in oriental persons.
In our cases, the patient had symptomes of chronic intestinal ischemia, including postprandial abdminal pain, weight loss associated with malnutrition, and moderate diarrhea for 3 months before admission.
A mesenteric angiogram was performed under the impression of ischemic bowel disease and revealed the typical "meandering mesenteric artery" with prominent Arc of Riolan, collateral vessel between superior mesenteric artery and inferior mesenteric
artery. Also, the Doppler ultrasound revealed that the superior mesenteric artery was nearly occluded. 3mm in diameter, compared with 9mm in average.
In conclusion, the chronic visceral ischemia is rare in incidence, but should be remembered in case of postprandial abdominal pain and weight loss without evidence of internal malignancy.
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