Vascular reconstruction in intestinal angina.

Chronic intestinal ischemia is rare because of the great capacity to form abundant collaterals. The experience with ten patients is discussed and the literature is reviewed. Diagnosis is easily missed because of the lack of specific symptoms. All but one of the patients showed the classical triad (postprandial pain, weight loss, epigastric bruit). The diagnostic value of endoscopy based on remarkable ischemic mucosal findings is stressed. These findings have not been described before. Most of the patients suffered from generalized atherosclerosis and therefore had a high operative risk. There was a considerable postoperative morbidity, but no postoperative mortality. In all patients long-term results were satisfactory. Vascular reconstruction is strictly indicated in case of intestinal angina, not only to diminish severe complaints, but also to prevent acute ischemic infarction. In our opinion there is no indication for prophylactic surgery in case of asymptomatic arterial stenosis or occlusion.