Chronic mesentric ischemia- an uncommon entity

Back ground: Chronic mesenteric ischemia (CMI), often a consequence of atherosclerosis in the abdominal aorta, occurs when the blood supply to the intestines is reduced or blocked. This condition can lead to a variety of symptoms, including postprandial abdominal pain (abdominal angina), weight loss, and food avoidance. Case Report: Afourty five-year-old male chronic smoker, patient presented with pain abdomen for last one year. The pain abdomen used to occur typically after meals, it used to start after 30-45 minutes of taking meal and used to slowly reach to its peak within next one hour and get resolved after two to three hours. He developed phobia of eating food and lost ten Kg of weight in last one year. The pain was associated with nausea & vomiting but there was no history of hematemesis or melena. All his baseline biochemical labs were essentially normal except for anemia and hypoproteinemia. The chest x-ray and ultrasonogram abdomen were normal. In view of classical history of abdominal angina, abdominal aortogram was done which revealed diffuse atherosclerotic changes in aortic arch, abdominal aorta, common iliac, external and internal iliac arteries. Conclusion: Chronic mesenteric ischemia is a diagnostic challenge but symptoms like unexplained weight loss and post prandial abdominal pain should alarm the treating team for considering it as a differential diagnosis and detailed work up for the same will lead to timely diagnosis and proper management which will lead to morbidity as well as mortality