Clinical management of chronic mesenteric ischemia

Louisa J. D. van Dijk*, Desiree van Noord, Annemarie C. de Vries, Jeroen J. Kolkman, Robert H. Geelkerken, Hence J. M. Verhagen, Adriaan Moelker, Marco J. Bruno, Ron Balm, Gert Jan de Borst, Juliette T. Blauw, Olaf J. Bakker, Hessel C. J. L. Buscher, Bram Fioole, Jaap F. Hamming, Jihan Harki, Daniel A. F. van den Heuvel, Eline S. van Hattum, Jan Willem Hinnen, Maarten J. van der LaanKaatje Lenaerts, Maikel P. Peppelenbosch, Andre S. van Petersen, Pepijn Rijnja, Peter J. van der Schaar, Luke G. Terlouw, Jean Paul P. M. de Vries, Dammis Vroegindeweij, Dutch Mesenteric Ischemia Study group

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

19 Citations (Web of Science)

Abstract

This review provides an overview on the clinical management of chronic mesenteric ischemia (CMI). CMI is defined as insufficient blood supply to the gastrointestinal tract, most often caused by atherosclerotic stenosis of one or more mesenteric arteries. Patients classically present with postprandial abdominal pain and weight loss. However, patients may present with, atypically, symptoms such as abdominal discomfort, nausea, vomiting, diarrhea or constipation. Early consideration and diagnosis of CMI is important to timely treat, to improve quality of life and to prevent acute-on-chronic mesenteric ischemia. The diagnosis of CMI is based on the triad of clinical symptoms, radiological evaluation of the mesenteric vasculature and if available, functional assessment of mucosal ischemia. Multidisciplinary consensus on the diagnosis of CMI is of paramount importance to adequately select patients for treatment. Patients with a consensus diagnosis of single-vessel or multi-vessel atherosclerotic CMI are preferably treated with endovascular revascularization.

Original languageEnglish
Pages (from-to)179-188
Number of pages10
JournalUnited European Gastroenterology Journal
Volume7
Issue number2
DOIs
Publication statusPublished - Mar 2019

Keywords

  • Chronic mesenteric ischemia
  • atherosclerosis
  • median arcuate ligament syndrome
  • computed tomography angiography
  • endovascular therapy
  • GASTRIC EXERCISE TONOMETRY
  • VISIBLE-LIGHT SPECTROSCOPY
  • ARTERY
  • REVASCULARIZATION
  • MORTALITY
  • DIAGNOSIS
  • STENOSIS

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