title: Splanchnic artery stenosis and abdominal complaints: clinical history is of limited value in detection of gastrointestinal ischemia.
abstract: BACKGROUND
  Splanchnic artery stenosis is common and mostly asymptomatic and may lead to gastrointestinal ischemia (chronic splanchnic syndrome, CSS). This study was designed to assess risk factors for CSS in the medical history of patients with splanchnic artery stenosis and whether these risk factors can be used to identify patients with high and low risk of CSS.
  
  
  METHODS
  All patients referred for suspected CSS underwent a standardized workup, including a medical history with questionnaire, duplex ultrasound, gastrointestinal tonometry, and angiography. Definitive diagnosis and treatment advice was made in a multidisciplinary team. Patients with confirmed CSS were compared with no-CSS patients.
  
  
  RESULTS
  A total of 270 patients (102 M, 168 F; mean age, 53 years) with splanchnic artery stenosis were analyzed, of whom 109 (40%) had CSS and 161 no CSS. CSS-patients more often reported postprandial pain (87% vs. 72%, p = 0.007), weight loss (85% vs. 70%, p = 0.006), adapted eating pattern (90% vs. 79%, p = 0.005) and diarrhea (35% vs. 22%, p = 0.023). If none of these risk factors were present, the probability of CSS was 13%; if all were present, the probability was 60%. Adapted eating pattern (odds ratio (OR) 3.1; 95% confidence interval (CI) 1.08-8.88) and diarrhea (OR 2.6; 95% CI 1.31-5.3) were statistically significant in multivariate analysis.
  
  
  CONCLUSIONS
  In patients with splanchnic artery stenosis, the clinical history is of limited value for detection of CSS. A diagnostic test to detect ischemia is indispensable for proper selection of patients with splanchnic artery stenosis who might benefit from treatment.
authors.affiliation: Department of Gastroenterology, University Medical Centre Groningen, Hanzeplein 1, Postbox 30001, 9700 RB, Groningen, The Netherlands. rinzetersteege@hotmail.com
authors.forename: R W F
authors.initials: RW
authors.lastname: ter Steege
authors.forename: H S
authors.initials: HS
authors.lastname: Sloterdijk
authors.forename: R H
authors.initials: RH
authors.lastname: Geelkerken
authors.forename: A B
authors.initials: AB
authors.lastname: Huisman
authors.forename: J
authors.initials: J
authors.lastname: van der Palen
authors.forename: J J
authors.initials: JJ
authors.lastname: Kolkman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis*; D003251:Constriction, Pathologic; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000209:etiology; D041981:Gastrointestinal Tract / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D012307:Risk Factors; D013152:Splanchnic Circulation; D055815:Young Adult