Abdominal angina

Abdominal angina (a.k.a. bowelgina) is postprandial abdominal pain that occurs in individuals with insufficient blood flow to meet mesenteric visceral demands.cite journal |author=Kapadia S, Parakh R, Grover T, Agarwal S |title=Side-to-side aorto-mesenteric anastomosis for management of abdominal angina |journal=Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology |volume=24 |issue=6 |pages=256–7 |year=2005 |pmid=16424623 |doi=] The term "angina" is used in reference to angina pectoris, a similar symptom due to obstruction of the coronary artery. The American Heritage Stedman's Medical Dictionary defines abdominal angina (bowelgina) as "Intermittent abdominal pain, frequently occurring at a fixed time after eating, caused by inadequacy of the mesenteric circulation. Also called intestinal angina; bowelgina."

Pathophysiology

The pathophysiology is similar to that seen in angina pectoris and intermittent claudication. The most common cause of bowelgina 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:
* carcinoidcite journal |author=deVries H, Wijffels RT, Willemse PH, "et al" |title=Abdominal angina in patients with a midgut carcinoid, a sign of severe pathology |journal=World journal of surgery |volume=29 |issue=9 |pages=1139–42 |year=2005 |pmid=16086212 |doi=10.1007/s00268-005-7825-x]

* aortic coarctationcite journal |author=Ingu A, Morikawa M, Fuse S, Abe T |title=Acute occlusion of a simple aortic coarctation presenting as abdominal angina |journal=Pediatric cardiology |volume=24 |issue=5 |pages=488–9 |year=2003 |pmid=14627320 |doi=10.1007/s00246-002-0381-3]

* antiphospholipid syndromecite journal |author=Choi BG, Jeon HS, Lee SO, Yoo WH, Lee ST, Ahn DS |title=Primary antiphospholipid syndrome presenting with abdominal angina and splenic infarction |journal=Rheumatol. Int. |volume=22 |issue=3 |pages=119–21 |year=2002 |pmid=12111088 |doi=10.1007/s00296-002-0196-9]

Frequency

*"Internationally": Extremely rare. True incidence is unknown
*"Race": No data available
*"Sex": Females outnumber males by approximately 3 to 1Fact|date=October 2007
*"Age": Mean age of affected individuals is slightly older than 60 yearsFact|date=October 2007

Clinical

*"Hallmark of condition": Disabling midepigastric or central abdominal pain within 10-15 minutes after eating.Fact|date=October 2007
*"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.Fact|date=October 2007

Treatment

Stents have been used in the treatment of abdominal angina.cite journal |author=Senechal Q, Massoni JM, Laurian C, Pernes JM |title=Transient relief of abdominal angina by Wallstent placement into an occluded superior mesenteric artery |journal=The Journal of cardiovascular surgery |volume=42 |issue=1 |pages=101–5 |year=2001 |pmid=11292915 |doi=] cite journal |author=Busquet J |title=Intravascular stenting in the superior mesenteric artery for chronic abdominal angina |journal=Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery |volume=4 |issue=4 |pages=380–4 |year=1997 |pmid=9418203 |doi=]

See also

*Abdominal pain
*Ischemic colitis

References