Abdominal Pain in the Elderly: An Unusual Case of Chronic Mesenteric Ischemia in the Emergency Department

Abstract

Chronic mesenteric ischemia (CMI) is a rare cause of abdominal pain with the potential for significant morbidity and mortality. An infrequently described complication of CMI is acalculous cholecystitis. Historically, acalculous cholecystitis is thought to be multifactorial and usually occurs in the setting of severe illness. In CMI, the etiology is more likely chronic ischemia to the gallbladder leading to inflammation. We present a case of acalculous cholecystitis that presented insidiously in a patient with CMI.

An unusual case of chronic mesenteric ischemia: Case report

“…CMI is defined as visceral hypoperfusion involving at least two of the following: the celiac artery, the superior mesenteric artery, and the inferior mesenteric artery [1] . It is usually due to arteriosclerosis and presents with nonspecific systemic symptoms such as postprandial pain, weight loss, nausea, or diarrhea [4] .…”

“…Chronic mesenteric ischemia is a rare, but potentially fatal [1] . CMI is an abdominal artery-occlusive disease that causes abdominal symptoms due to poor blood supply to the gastrointestinal tract [2] .…”

Therapeutic Effect of Nangan-geon for an Elderly Patient with Refractory Abdominal Pain: a Case Report

“…The continuous increase of aged population raises a medical issue of abdominal pain in elderly. A wide range of disorders can cause abdominal pain in the geriatric population, from a constipation to diseases in biliary tract, bowel obstruction, gastric ulcer, appendicitis, pancreatitis, urogenital diseases or mesenteric ischemia 4) . including computerized tomography (CT) scan significantly improved the accurate and rapid diagnosis of causative condition of abdominal pain, many cases of elderly patients tend to present the vague pain without specific findings on examinations 5,6) .…”