Chronic atherosclerotic disease of the vessels supplying the intestine

Aetiology

• Patients are typically female and between 50 and 70 years of age
• Usually have other coexisting manifestations of atherosclerotic disease

Clinical features

• Moderate-to-severe colicky or constant and poorly localised pain
• Weight loss, postprandial pain and a fear of eating
• Other nonspecific symptoms may include nausea, vomiting, or bowel irregularity

Investigations

• Arteriography: gold standard investigation to show the site of arterial blockage or stenosis

Management

• Asymptomatic patients are managed conservatively, with smoking cessation and antiplatelet therapy
• Symptomatic chronic mesenteric ischaemia is an indication for either open or endovascular revascularisation