Abdominal angina

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Abdominal angina
ICD-10 K55
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

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

Renovascular Disease,

Rheum / Immune / Allergy

Henoch-Schonlein purpura, Vasculitis,

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

de:Angina abdominalis

Template:WikiDoc Sources

  1. The American Heritage Stedman's Medical Dictionary. "KMLE Medical Dictionary Definition of abdominal angina".
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.