Cigarette Smoking: The Only Risk Factor of a Case with Chronic Mesenteric Ischemia

  • Cemile Özsürekci HACETTEPE UNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ, İÇ HASTALIKLARI A.B.D/GERİATRİ B.D
  • Hatice Çalışkan HACETTEPE UNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ, İÇ HASTALIKLARI A.B.D/GERİATRİ B.D
  • Gözde Şengül Ayçiçek HACETTEPE UNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ, İÇ HASTALIKLARI A.B.D/GERİATRİ B.D
  • Rana Tuna Doğrul HACETTEPE UNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ, İÇ HASTALIKLARI A.B.D/GERİATRİ B.D
  • Cafer Balcı HACETTEPE UNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ, İÇ HASTALIKLARI A.B.D/GERİATRİ B.D
  • Fatih Sümer HACETTEPE UNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ, İÇ HASTALIKLARI A.B.D/GERİATRİ B.D
  • Barbaros Çil HACETTEPE UNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ, RADYOLOJİ A.B.D
  • Burcu Balam Yavuz HACETTEPE UNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ, İÇ HASTALIKLARI A.B.D/GERİATRİ B.D
  • Mustafa Cankurtaran HACETTEPE UNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ, İÇ HASTALIKLARI A.B.D/GERİATRİ B.D
  • Meltem Gülhan Halil HACETTEPE UNİVERSİTESİ TIP FAKÜLTESİ HASTANESİ, İÇ HASTALIKLARI A.B.D/GERİATRİ B.D

Abstract

Chronic mesenteric ischemia (CMI) is a rare condition and ıt could be mis-diagnosed becouse lack of specific signs. Patients with chronic mesenteric ischemia (CMI) typically present with a history of the chronic intermittent abdominal pain, fear of eating and weight loss. The etiology of chronic mesenteric ischemia is multifactorial which includes atherosclerosis risk factors such as diabetes, hypertension, hyperlipidemia, smoking and obesity. Herein, we present a case whose only risk factor was smoking and presented with subacute abdominal pain. A 74-year-old woman was admitted to outpatient clinic with continuous abdominal pain, vomiting and diarrhea for 2 weeks. She had no other symptoms and chronic diseases. She is an active smoker for 58 pacs/year. Her physical examination revealed that diffuse abdominal pain without peritoneal signs. Laboratory results demonstrated an inflammatory condition however, abdominal ultrasound and endoscopic examination were in normal limits. Contrast enhanced abdominal CT revealed acute exacerbation of CMI.  The patients treated with endovascular stent implantation and all symptoms were resolved. Chronic mesenteric ischemia could seen with atypical presentations, solely due to smoking without multiple risk factors in older patients. Therefore, it should be remembered that the diseases may be encountered in atypical presentations in older patients . Moreover, smoking habits should be questioned and patients should be reminded about smoking cessation.

References

Hohenwalter EJ. Chronic mesenteric ischemia: diagnosis and treatment. Semin Interv Radiol. 2009;26:345–51.

Allen RC, Martin GH, Rees CR. Mesenteric Angioplasty in the treatment of Chronic Intestinal ischemia. J Vasc Surg. 1996;24:415–23.

Mikkelson WP. Intestinal Angina: Its surgical significance. Am J Surg. 1957;94:262–9.

Herrington W, Lacey B, Sherliker P, Armitage J, Lewington S. Epidemiology of Atherosclerosis and the Potential to Reduce the Global Burden of Atherothrombotic Disease. Circ Res. 2016 Feb 19;118(4):535-46.

Published
2019-12-21