Health

Role of Doppler ultrasound studies in diagnosis of abdominal angina Doppler ultrasound is a noninvasive test that evaluates the patency of and blood flow through the major mesenteric vessels. It should be performed while the patient is fasting and subsequently meal-stimulated. It is most helpful in diagnosing multivessel stenosis in suspected mesenteric angina by demonstrating narrowing …

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What is the role of magnetic resonance angiography (MRA) in patients with suspected abdominal angina?  In patients with suspected abdominal angina, MRA may be helpful in those with a severe iodine allergy. Good correlation with CT angiography has been demonstrated, and three-dimensional reconstruction allows for visualization of splanchnic orifices.  Additionally, in patients with chronic kidney …

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What are the differential diagnostic considerations in a patient with suspected AMI, and how do plain abdominal radiographs help elucidate the disorder?  Flat and upright abdominal plain films should be obtained first in a patient complaining of abdominal pain unless a diagnosis of ischemia is clear.  The below table depicts differential diagnoses and associated findings …

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Do lab findings help in mesenteric ischemia?  In the early stages of mesenteric ischemia there are no specific abnormal laboratory values, only those that are associated with the underlying condition from which the ischemia developed. Nonspecific laboratory abnormalities that develop over the course of the disease process are a result of the consequence of ischemia …

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What are the physical findings in a patient with mesenteric ischemia?  Again, the physical findings associated with mesenteric ischemia vary based on etiologic factors and duration of ischemia. The classic finding of a patient with an acute occlusion of the SMA is abdominal pain out of proportion to physical examination findings. Early in the course of the …

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What are the common symptoms of occlusive mesenteric ischemia?  The common presenting symptoms of occlusive mesenteric ischemia vary by the cause of ischemia. Patients with mesenteric ischemia caused by an acute embolus or thrombotic occlusion of the SMA usually present with the abrupt onset of severe, colicky, midabdominal pain. These patients may also become incontinent of bowel function because …

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What is focal segmental (short segment) ischemia?  Focal segmental ischemia refers to ischemia that is confined to a short segment of bowel because it involves only a few small arteries or veins. This occurs by the same pathophysiologic processes that cause extensive bowel ischemia.