title: Functional testing in the diagnosis of chronic mesenteric ischemia.
abstract: Chronic mesenteric ischemia (CMI) results from insufficient oxygen delivery or utilization to meet metabolic demand. Two main mechanisms may lead to mesenteric ischemia: occlusion in the arteries or veins of the gastrointestinal tract, or reduced blood flow from shock states or increased intra-abdominal pressure, so-called non-occlusive mesenteric ischemia. Severe stenoses in the three main mesenteric vessels as demonstrated with CT-angiography or MR-angiography are sufficient to proof mesenteric ischemia, for example in patients who present with weight loss, postprandial pain and diarrhea. Still in many clinical situations mesenteric ischemia is only one of many possible explanations. Especially in patients with a single vessel stenosis in the celiac artery or superior mesenteric artery with postprandial pain, mesenteric ischemia remains a diagnosis of probability or assumption without functional proof of actual ischemia. This review is aimed to provide an overview of all past, present and future ways to functionally proof CMI.
authors.affiliation: Erasmus MC University Medical Center Rotterdam, Department of Gastroenterology and Hepatology, Rotterdam, The Netherlands; Franciscus Gasthuis & Vlietland, Department of Gastroenterology and Hepatology, Rotterdam, The Netherlands. Electronic address: d.leemreis@franciscus.nl.
authors.forename: Desirée
authors.initials: D
authors.lastname: van Noord
authors.affiliation: Medisch Spectrum Twente, Department of Gastroenterology and Hepatology, Enschede, The Netherlands; Universitair Medisch Centrum Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands. Electronic address: j.kolkman@mst.nl.
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Kolkman
mesh_terms: D002908:Chronic Disease; D006801:Humans; D008027:Light; D065666:Mesenteric Ischemia / Q000175:diagnosis*; D013057:Spectrum Analysis / Q000379:methods*
keywords: Chronic gastrointestinal ischemia; Chronic mesenteric ischemia; Chronic splanchnic ischemia; Functional test; Functional testing; Tonometry; Visible light spectroscopy