Abdominal angina
| Abdominal angina | |
| ICD-10 | K55 |
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| ICD-9 | 557.1 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor in Chief: M.Umer Tariq [2]
Overview
Abdominal angina (a.k.a. bowelgina) is postprandial abdominal pain that occurs in individuals with insufficient blood flow to meet visceral demands. 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." [1]
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:
Frequency
- 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
Complete Differential Diagnosis of the causes of Abdominal angina
- Atheroma
- Atherosclerosis
- Henoch-Schonlein purpura
- Ortner's syndrome II
- Peripheral artery occlusive disease
- Renovascular Disease
- Vasculitis
Complete Differential Diagnosis of the Causes of Abdominal angina
(By organ system)
| Cardiovascular |
Atheroma, Atherosclerosis, Peripheral artery occlusive disease, Renovascular Disease, Ortner's syndromeII, |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | No underlying causes |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional / Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal / Electrolyte | |
| Rheum / Immune / Allergy | |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
Clinical
- 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 aorto-iliac occlusive disease, may be present.
- Causes: Smoking is an associated risk factor. In most series, approximately 75-80% of patients smoke.
Treatment
Stents have been used in the treatment of abdominal angina.[5][6]
See also
Template:Eponymous medical signs for digestive system and general abdominal signs Template:Gastroenterology
- ↑ The American Heritage Stedman's Medical Dictionary. "KMLE Medical Dictionary Definition of abdominal angina".
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Busquet J (1997). "Intravascular stenting in the superior mesenteric artery for chronic abdominal angina". Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery. 4 (4): 380–4. PMID 9418203.