Abdominal angina

Abdominal angina is abdominal pain after eating that occurs in individuals with ongoing poor blood supply to their small intestines known as chronic mesenteric ischemia.[1] Although the term angina alone usually denotes angina pectoris (a type of chest pain due to obstruction of the coronary artery), angina by itself can also mean "any spasmodic, choking, or suffocative pain",[2] with an anatomic adjective defining its focus; so, in this case, spasmodic pain in the abdomen. Stedman's Medical Dictionary Online[3] defines abdominal angina as "intermittent abdominal pain, frequently occurring at a fixed time after eating, caused by inadequacy of the mesenteric circulation resulting from arteriosclerosis or other arterial disease. Synonym: intestinal angina."

Abdominal angina
Other namesIntestinal angina
SpecialtyGeneral surgery

Signs and symptoms
  • Hallmark of condition: Disabling midepigastric or central abdominal pain within 10–15 minutes after eating.
  • Physical examination: The abdomen typically is scaphoid and soft, even during an episode of pain. Patients present with stigmata of weight loss and signs of peripheral vascular disease, particularly aortoiliac occlusive disease, may be present.

Causes

Smoking is an associated risk factor. In most series, approximately 75–80% of patients smoke.

Pathophysiology

The pathophysiology is similar to that seen in angina pectoris and intermittent claudication. The most common cause of abdominal angina is atherosclerotic vascular disease, where the occlusive process commonly involves the ostia and the proximal few centimeters of the mesenteric vessels. It can be associated with:

Epidemiology
  • Internationally: Extremely rare. True incidence is unknown
  • Race: No data available
  • Sex: Females outnumber males by approximately 3 to 1
  • Age: Mean age of affected individuals is slightly older than 60 years

Treatment

Stents have been used in the treatment of abdominal angina.[7][8]

See also

References
  1. Kapadia S, Parakh R, Grover T, Agarwal S (2005). "Side-to-side aorto-mesenteric anastomosis for management of abdominal angina". Indian Journal of Gastroenterology. 24 (6): 256–7. PMID 16424623.
  2. Elsevier, Dorland's Illustrated Medical Dictionary, Elsevier.
  3. Wolters Kluwer, Stedman's Medical Dictionary, Wolters Kluwer.
  4. deVries H, Wijffels RT, Willemse PH, et al. (2005). "Abdominal angina in patients with a midgut carcinoid, a sign of severe pathology". World Journal of Surgery. 29 (9): 1139–42. doi:10.1007/s00268-005-7825-x. PMID 16086212.
  5. Ingu A, Morikawa M, Fuse S, Abe T (2003). "Acute occlusion of a simple aortic coarctation presenting as abdominal angina". Pediatric Cardiology. 24 (5): 488–9. doi:10.1007/s00246-002-0381-3. PMID 14627320.
  6. Choi BG, Jeon HS, Lee SO, Yoo WH, Lee ST, Ahn DS (2002). "Primary antiphospholipid syndrome presenting with abdominal angina and splenic infarction". Rheumatol. Int. 22 (3): 119–21. doi:10.1007/s00296-002-0196-9. PMID 12111088.
  7. Senechal Q, Massoni JM, Laurian C, Pernes JM (2001). "Transient relief of abdominal angina by Wallstent placement into an occluded superior mesenteric artery". The Journal of Cardiovascular Surgery. 42 (1): 101–5. PMID 11292915.
  8. Busquet J (1997). "Intravascular stenting in the superior mesenteric artery for chronic abdominal angina". Journal of Endovascular Surgery. 4 (4): 380–4. doi:10.1583/1074-6218(1997)004<0380:ISITSM>2.0.CO;2. ISSN 1074-6218. PMID 9418203.
Classification
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