A 74 year old man develops severe, steady, mild abdominal pain approximately 30 minutes after eating. He has lost 12 Kg over the past few months because he wants to avoid the pain after eating. Abdominal examination during an asymptomatic interval is normal. Stool guaiac examination results are negative, as colonoscopy and barium studies. The complete blood count is normal. What is the most likely diagnosis?
High-Yield Explanation
Mesenteric angina commonly occurs in elderly men. It is characterized by severe midabdominal pain approximately 30 minutes after eating, when splanchnic blood flow is greatest. The pain is so intense that patient is fearful of eating and subsequent weight loss. Potential problems include ischemic damage to the large bowel, with subsequent development of fibrosis and strictures leading to bowel obstruction.