Relief of Abdominal Angina by Vascular Graft

Abstract

Mesenteric arterial insufficiency produces a syndrome of "abdominal angina" with post-pradial cramping abdominal pain, weight loss and malnutrition due to disorders of intestinal motility and absorption. The malabsorption can be demonstrated by absorption studies of D-xylose, radioactive iodine iodine tagged oleic acid, amino acids, or Vitamins A and B12. The site of arterial stenosis can be demonstrated by aortography. Most cases are due to arteriosclerotic narrowing of the first centimeter of the celiac, superior mesenteric or inferior mesenteric artery or combinations of these. Since the distal arterial tree is usually relatively normal, revascularization can be accomplished either by endarterectomy or bypass grafts. A case of abdominal angina is presented which was successfully rehabilitated by a bypass graft from the aorta to the superior mesenteric artery. Improvement was demonstrated by pre- and postoperative pressure measurements and absorption studies and the patient''s clinical course. Chronic mesenteric vascular should be considered in any older patient with obscure gastrointestinal complaints, especially since in many cases modern vascular techniques can offer complete relief.