Abdominal angina pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Abdominal angina is an unusual cause of intermittent abdominal pain. Arterial vascular insufficiency is the cause of abdominal angina.The term angina is used because the pain develops only after eating, due to diminshed arterial supply that's needed to meet the increased demands to support digestion [1]. It's due to reduced mesenteric blood flow, reduced oxygen content of red blood cells distributed via the mesenteric arterial circulation, or mesenteric venous stasis, any of which can lead to tissue hypoxia and ischemic injury[1]
Pathophysiology
- The pathophysiology is similar to that seen in angina pectoris and intermittent claudication.
- Abdominal angina occurs due to narrowing of the mesenteric vessels that causes decreased blood flow.[2]
- Atherosclerotic vascular disease at ostia of the mesenteric vessels is the most common cause of abdominal angina . Superior mesenteric artery occlusion is often found in patients presenting symptomatic occlusive mesenteric ischemia. Patients with abdominal angina are unable to increase flow in the mesenteric vessels in response to eating that's why they develop postprandial pain.[2]
It can be associated with:
- carcinoid[3]
- Carinoid tumors can synthesis different types of amine and peptides, like serotonin, 5-hydroxytryptophan, ACTH, substance P, motilin, met-enkephalin, P-endorphin, neurotensin, gastrin, and somatostatin, but the agent which responsible for mesenteric vascular ischemia. Many of these substances have action on smooth muscles like substance P, motilin, and neurotensin which might have a role in the development of vascular elastosis.[4]
- Midgut carcinoids are known to be more endocrinologically active than those arising from the hindgut, which may be the cause of the fact that elastic vascular sclerosis has not been found in the latter [4]
References
- ↑ 1.0 1.1 "www.sciencedirect.com".
- ↑ 2.0 2.1 "Abdominal Angina - StatPearls - NCBI Bookshelf".
- ↑ 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.
- ↑ 4.0 4.1 "www.ncbi.nlm.nih.gov" (PDF).
- ↑ 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.
- ↑ 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.