title: Diagnosis of chronic mesenteric ischemia in older patients: a structured review.
abstract: OBJECTIVE
  Chronic mesenteric ischemia in older patients is a challenge for the physician because it coincides with a vague and non-specific clinical presentation with abdominal pain. It can frequently cause diagnostic errors and lead to legal consequences. The aim of this work was to evaluate the literature on chronic mesenteric ischemia and focus on the limited data concerning the geriatric population.
  
  
  METHODS
  This research focused on observational studies, randomized controlled trials, and clinical reports (excluding case reports and reviews) dealing with patients at least 65 years old with a clinical or instrumental diagnosis of chronic intestinal ischemia, published between 2000 and 2010. The search was conducted in PubMed using the following key words: chronic ischemic splanchnic disease, chronic mesenteric ischemia, angina abdominis, chronic abdominal angina, intestinal ischemia.
  
  
  RESULTS
  We selected 925 articles with the key words as follows: chronic mesenteric ischemia in 355 cases; chronic ischemic splanchnic disease in 46; angina abdominis in 4; abdominal angina in 242; and chronic intestinal ischemia in 278. We then excluded articles judged scarcely pertinent, case reports, reviews, works concentrating only on diagnostic, methodological, instrumental and surgical approaches, and articles based on animal or experimental models. This selection left us with 13 articles (after excluding duplicates), only three of which were considered valid for our purposes.
  
  
  CONCLUSIONS
  Our review indicates that there is a shortage of useful literature on chronic intestinal ischemic disease diagnosed in the older adults, and the appropriate geriatric management of these patients is consequently not well established.
authors.affiliation: Geriatric Department, Division of Geriatric Surgery, University of Padua, Via Giustiniani 1, 35126 Padua, Italy. fabrizio.cardin@sanita.padova.it
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Cardin
authors.forename: Stefania
authors.initials: S
authors.lastname: Fratta
authors.forename: Emine Meral
authors.initials: EM
authors.lastname: Inelmen
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sergi
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.forename: Claudio
authors.initials: C
authors.lastname: Terranova
mesh_terms: D015746:Abdominal Pain / Q000503:physiopathology; D000368:Aged; D003951:Diagnostic Errors; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D065666:Mesenteric Ischemia; D008875:Middle Aged; D014463:Ultrasonography; D014652:Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology