[Advanced abdominal angina due to atherosclerosis with atypical celiac arteries].
It is generally accepted that the abdominal angina develops only when at least two of the three splanchnic vessels-mesenteric arteries and the celiac trunk exhibit a critical obstruction. That common opinion does not, however, take into account anatomical variants of arteries supplying the blood to the intestines. We present a case of a wasted, 40 year old male with a wide spread arteriosclerosis and postprandial pain. The ultrasound examination revealed total occlusion of the superior mesenteric artery (SMA). Celiac trunk (CT) and inferior mesenteric artery (IMA) were patent. The ultrasound indicated that only one splanchic vessel was obstructed; the systemic disorder, the neoplasm, as well as the malabsorption were ruled out. An arteriography of the abdominal aorta and of splanchnic arteries confirmed patency of CT and IMA, also lack of flow in the SMA. Atypical origin of the middle colic artery originating from the bed of CT was also shown. Lack of collaterals between IMA and SMA, typically conducting a sufficient blood flow, resulted in a fully symptomatic abdominal angina. Symptoms were relieved following surgical revascularization.
Makowski
M
M
II Katedra Chorób Wewnetrznych, Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Bartlewicz
J
J
Krzanowski
M
M
Nizankowski
R
R
Szczeklik
A
A
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D001161:Arteriosclerosis / Q000150:complications*; D002445:Celiac Artery / Q000002:abnormalities*; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D019518:Postprandial Period; D014463:Ultrasonography