A 55-year-old woman presents with postprandial abdominal pain, fear of eating, and 10 kg weight loss over 3 months. She has a history of coronary artery disease. CT angiography reveals significant stenosis of the proximal celiac artery and superior mesenteric artery. What is the most likely diagnosis?
- A Acute mesenteric ischemia
- B Chronic mesenteric ischemia (intestinal angina) ✓
- C Irritable bowel syndrome
- D Chronic pancreatitis
Correct answer: B. Chronic mesenteric ischemia (intestinal angina)
Explanation
Chronic mesenteric ischemia classically presents with intestinal angina: postprandial abdominal pain leading to food aversion and weight loss. It results from atherosclerotic stenosis of at least two of the three mesenteric vessels. The chronic time course and weight loss distinguish it from acute mesenteric ischemia, which presents with sudden severe pain and often haemodynamic instability.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.