Clinical significance of splanchnic artery stenosis.
BACKGROUND
The clinical relevance of splanchnic artery stenosis is often unclear. Gastric exercise tonometry enables the identification of patients with actual gastrointestinal ischaemia. A large group of patients with splanchnic artery stenosis was studied using standard investigations, including tonometry.


METHODS
Patients referred with possible intestinal ischaemia were analysed prospectively, using duplex imaging, conventional abdominal angiography and tonometry. All results were discussed within a multidisciplinary team.


RESULTS
Splanchnic stenoses were found in 157 (49.7 percent) of 316 patients; 95 patients (60.5 percent) had one-vessel, 54 (34.4 percent) two-vessel and eight (5.1 percent) had three-vessel disease. Chronic splanchnic syndrome was diagnosed in 107 patients (68.2 percent), 54 (57 percent) with single-vessel, 45 (83 percent) with two-vessel and all eight with three-vessel stenoses. Treatment was undertaken in 95 patients, 62 by surgery and 33 by endovascular techniques. After a median follow-up of 43 months, 84 percent of patients were symptom free.


CONCLUSIONS
Gastric exercise tonometry proved crucial in the evaluation of possible intestinal ischaemia. Comparing patients with single- and multiple-vessel stenoses, there were significant differences in clinical presentation and mortality rates.
Mensink
P B F
PB
Department of Internal Medicine and Gastroenterology, Medisch Spectrum Twente, Enschede, The Netherlands. pbfmensink@wanadoo.nl
van Petersen
A S
AS
Geelkerken
R H
RH
Otte
J A
JA
Huisman
A B
AB
Kolkman
J J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D032921:Consensus; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007422:Intestines / Q000098:blood supply; D007511:Ischemia / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008365:Manometry; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D013152:Splanchnic Circulation / Q000502:physiology*; D018608:Ultrasonography, Doppler