Published: 2017-07-24

A case of chronic mesenteric ischemia managed by ascending aorta to superior mesenteric and hepatic artery bypass

Harilal V. Nambiar, Robin George Manappallil, Sylesh Aikot, Pramod V.


Chronic mesenteric ischemia is a rare and life-threatening condition which occurs due to occlusion of two or more mesenteric arteries following atherosclerosis. Multi-vessel revascularization forms the mainstay of treatment. This is a case of a middle-aged smoker who presented with abdominal angina and was diagnosed to have chronic mesenteric ischemia due to atherosclerotic occlusive aortic disease with coeliac artery and superior mesenteric artery occlusion. He was successfully managed with extra anatomic bypass from the ascending aorta to superior mesenteric and hepatic artery.


Abdominal angina, Chronic mesenteric ischemia, Coeliac artery, Hepatic artery, Superior mesenteric artery

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Kilsby A, Pasha Y. Chronic mesenteric ischaemia: a battery of negative tests in a patient with episodic abdominal pain, weight loss and diarrhoea. BMJ Case Rep. 2013:2013.

Cunningham CG, Reilly LM, Rapp JH, Schneider PA, Stoney RJ. Chronic visceral ischemia: three decades of progress. Ann Surg. 1991;214(3):276-88.

McMillan WD, McCarthy WJ, Bresticker MR, Pearce WH, Schneider JR, Golan JF, et al. Mesenteric artery bypass: objective patency determination. J Vasc Surg. 1995;21(5):729-40.

Johnston KW, Lindsay TF, Walker PM, Kalman PG. Mesenteric arterial bypass grafts: early and late results and suggested surgical approach for chronic and acute mesenteric ischemia. Surg. 1995;118(1):1-7.

Senadhi V. A rare cause of chronic mesenteric ischemia from fibromuscular dysplasia: a case report. J Med Case Reports. 2010;4:373.

Van De Winkel N, Cheragwandi A, Nieboer K, van Tussenbroek F, De Vogelaere K, Delvaux G. Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report. J Med Case Reports. 2012;6:48.

Abe S, Yamakawa T, Kawashima H, Yoshida M, Takanashi S, Kashiyama M. Surgery for acute exacerbation of chronic mesenteric ischemia: a case report. Surg Case Rep. 2016;2:146.