Elderly patients with chronic abdominal pain are commonly misdiagnosed, most likely due to atypical symptom presentations. Chronic mesenteric ischemia is a rare cause of chronic abdominal pain in the elderly. Symptoms are postprandial abdominal pain, weight loss, and an abdominal bruit. The disease results from atherosclerotic plaques that reduce the bowel’s ability to increase blood flow after meals. Patients often are malnourished. Diagnosis can be made with various imaging modalities, although a computed tomography angiogram is likely needed when the syndrome is suspected. The mainstay of therapy for chronic mesenteric ischemia is surgical intervention. Interventional pain techniques, such as celiac plexus neurolysis or spinal cord stimulation, are promising adjunct treatment options.
Dysplastic-Dependent Visceropathy and Syndrome of Chronic Abdominal Pain: the Hard Way to Diagnosis of Mesenteric Ischemia
