Profound Weight Loss Diagnosed as Chronic Mesenteric Ischemia

Christine Carroll^1* & Jeff Guthrie, A.²

¹Emergency Medicine Physician, Bayne Jones Army Community Hospital, Fort Polk, Louisiana
²Chief of Department of Radiology, Bayne Jones Army Community Hospital, Fort Polk, Louisiana

Dr. Christine Carroll, Emergency Medicine Physician, Bayne Jones Army Community Hospital, Fort Polk, Louisiana.

Keywords: Mesenteric Ischemia; Chronic Abdominal Pain; Weight Loss

Abstract

In cases of chronic abdominal pain in geriatric population a high index of suspicion needs to be maintained to gather data that would determine the emergency physician arrive to a diagnosis for appropriate patient management and referrals to the appropriate services. We present the case of an elderly patient who arrived at our Emergency Department after multiple visits for chronic abdominal pain and weight loss. She had an extensive prior workup that excluded malignancy and other overt etiologies yet she remained undiagnosed. Previous imaging did note severe atherosclerotic vascular disease, including severe narrowing of the celiac, superior mesenteric and inferior mesenteric arteries. Combing this information with a detailed history yielded the diagnosis of chronic mesenteric ischemia. This case should alert physicians that listening closely to the patient and combining that information with all available testing data may lead them to the correct diagnosis in complicated cases. This is especially important in situations when patients have prior negative workups with no findings but report continued worsening of their condition.

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