Master Chronic Mesenteric Ischemia with Picmonic for Medicine

Chronic mesenteric ischemia is also known as intestinal angina. It is mentioned as episodic or continuous small intestine hypoperfusion caused by multivessel mesenteric artery occlusion.

Chronic mesenteric ischemia is most commonly caused by atherosclerosis in the celiac, superior mesenteric, or inferior mesenteric arteries.

Single-vessel occlusion in chronic mesenteric ischemia is more commonly seen in the celiac artery than in the superior mesenteric artery.

The superior mesenteric artery is one of the blood vessels that can be occluded in chronic mesenteric ischemia.

The inferior mesenteric artery is one of the blood vessels that can be occluded in chronic mesenteric ischemia.

Chronic mesenteric ischemia patients most commonly experience epigastric pain in the first hour after eating, which is mentioned as postprandial epigastric pain. It can be described as a dull and crampy pain.

Postprandial epigastric pain will cause patients to avoid eating, known as food aversion or fear. This avoidance will result in weight loss due to the patient's expectation of postprandial pain and other symptoms.

CT angiography of the abdomen and pelvis is the best imaging study for diagnosing chronic mesenteric ischemia because it can exclude other disorders that can induce the same abdominal symptoms. The study can show the presence of stenosis in the major mesenteric vessels.

Anticoagulation is used to treat the presence of acute thrombus or acute-on-chronic mesenteric ischemia. Vasodilators and antibiotics can be used as adjuvant therapy if indicated in the patient.

Revascularization can be open or endovascular. This treatment is used to relieve symptoms, reduce the risk of bowel stricture due to infarction or ischemia, and reverse nutritional depletion and weight loss. Open revascularization includes aortomesenteric or celiac bypass grafting, mesenteric reimplantation, and transaortic endarterectomy. Endovascular options may include balloon angioplasty alone, percutaneous angioplasty and stenting, and retrograde open mesenteric stenting (hybrid technique).