Chronic mesenteric ischaemia is a pathological condition typically presenting in elderly patients, characterized by insufficient blood supply to the intestines, usually due to gradual blockage or narrowing of the mesenteric arteries.

Epidemiology

• relatively uncommon, primarily affecting the elderly population (60+)
• It is estimated that significant stenosis or occlusion of the celiac and mesenteric arteries, which leads to CMI, may be present in up to 7% of individuals over the age of 65.
• The condition appears to be slightly more prevalent in women compared to men, with a ratio of approximately 3:2.

Risk factors

• smoking
• HTN
• hyperlipidaemia
• history of cardiovascular disease
• AF

PC

• Diffuse, colicky abdominal pain, which worsens after eating
• Significant weight loss, as patients avoid eating due to the pain
• Diarrhoea
• Gastrointestinal bleeding, presenting as melaena or haematochezia (secondary to mucosal sloughing)

Physical examination often reveals abdominal tenderness. An epigastric bruit may be present, indicative of turbulent flow in the narrowed vessels.