A 62-year-old woman reports severe postprandial abdominal pain for eight months with marked weight loss and fear of eating. She has no gastrointestinal bleeding. Auscultation reveals an epigastric bruit. Which investigation is most appropriate to confirm the suspected diagnosis?

• A Colonoscopy with random biopsies
• B Gastric emptying study
• C CT angiography of the mesenteric vessels ✓
• D Faecal calprotectin measurement

Explanation

Chronic mesenteric ischaemia classically causes postprandial pain, food fear, and weight loss in a vasculopath, often with an epigastric bruit. Diagnosis requires demonstration of significant stenosis in at least two of the three mesenteric vessels, best shown by CT angiography. The weight loss pattern mimics malignancy, which is why endoscopy tempts candidates, but the vascular history and bruit direct angiographic imaging.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.