A 85-year-old man presents with severe crampy abdominal pain which is worse after eating, associated with frequent nausea, bloating and watery diarrhoea. His other medical problems include coronary aery disease, hypeension, hypercholesteremia. He has a 40-pack-year smoking history Barium enema is as shown. What is the most probable cause?
The diagnosis of chronic mesenteric ischemia should be suspected in the above patient. The barium enema demonstrates thumbprinting of the colonic wall, although nonspecific but seen in mesenteric ischemia. Most cases are due to atherosclerotic changes, especially in the background of smoking and coronary aery disease.
Left ventricular aneurysm
Transmural inflammation of the small intestine
Progressive pancreatic inflammation
Atherosclerosis of the mesenteric aeries
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