Institution: | a The Emergency Medicine Residency Training Program, Division of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada b The Department of Emergency Medicine, Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada c The Department of Emergency Medicine, Brigham and Women's Hospital, The Division of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA |
Abstract: | Mesenteric ischemia usually occurs in elderly patients, especially those with predisposing factors. It has also been described in young patients using oral contraceptive pills or illicit drags. We present a case of a middle-aged woman who developed acute focal ischemia of the small intestine without predisposing factors. The unusual presentation of this patient, combined with her relative youth, obscured the diagnosis, which was ultimately made at laparotomy. The diagnosis of mesenteric ischemia should be considered in patients of any age presenting with recurrent or severe abdominal pain, particularly when no alternative cause is apparent. The definitive study to diagnose mesenteric ischemia is angiography. Unless identified early in its course, the condition may progress to frank infarction with a significant increase in morbidity and mortality. Because of this, an aggressive approach to the diagnosis and therapy of mesenteric ischemia is essential. |