Delayed diagnosis of chronic mesenteric ischaemia.
Chronic mesenteric ischaemia is a rare disease. Patients typically present with a protracted course of vague abdominal symptoms and profound weight loss, leading to a delay in diagnosis. If untreated, it progresses to bowel infarction, which has a poor prognosis. Once diagnosed, however, it can be easily remedied via endovascular stenting or open surgery. Symptom reversal is prompt and patients rapidly achieve premorbid habitus. We report a 58-year-old man in whom the diagnosis was missed for two years, during which numerous investigations were performed. The diagnosis was eventually revealed on angiography, and he was cured by mesenteric bypass surgery. For patients with the triad of chronic, unrelenting weight loss, sitophobia (food fear) and postprandial abdominal pain, this condition must be considered, and actively sought after with angiography.
Woon
C Y L
CY
Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608. wolv23@gmail.com
Tay
K H
KH
Tan
S G
SG
D000714:Anastomosis, Surgical; D000792:Angiography; D001783:Blood Flow Velocity; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D002908:Chronic Disease; D003937:Diagnosis, Differential; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000000981:diagnostic imaging; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery; D008641:Mesenteric Vascular Occlusion / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008643:Mesentery / Q000098:blood supply*; D008875:Middle Aged; D011379:Prognosis; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D018616:Ultrasonography, Doppler, Duplex