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Case Reports
. 2021 Mar 5;14(3):e240202.
doi: 10.1136/bcr-2020-240202.

Chronic mesenteric ischaemia presenting as possible large bowl malignancy: an easily overlooked differential diagnosis

Benjamin McDonald  1
Affiliations
Case Reports

Chronic mesenteric ischaemia presenting as possible large bowl malignancy: an easily overlooked differential diagnosis

Benjamin McDonald. BMJ Case Rep. .

Abstract

An 80-year-old woman presented to a regional emergency department with postprandial pain, weight loss and diarrhoea for 2 months and a Computed Tomography (CT) report suggestive of descending colon malignancy. Subsequent investigations revealed the patient to have chronic mesenteric ischaemia (CMI) with associated bowel changes. She developed an acute-on-chronic ischaemia that required emergency transfer, damage control surgery and revascularisation. While the patient survived, this case highlights the importance of considering CMI in elderly patients with vague abdominal symptoms and early intervention to avoid potentially catastrophic outcomes.

Keywords: GI bleeding; general surgery; radiology; vascular surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Initial portovenous CT demonstrating significant coeliac trunk and superior mesenteric artery stenosis.
Figure 2
Figure 2
Computed Tomography Angiography again demonstrating critical stenosis.
See this image and copyright information in PMC

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