Abdominal angina

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Overview
Abdominal angina (a.k.a. bowelgina) is postprandial abdominal pain that occurs in individuals with insufficient blood flow to meet visceral demands. The term angina is used in reference to angina pectoris, a similar symptom due to obstruction of the coronary artery. The American Heritage Stedman's Medical Dictionary defines abdominal angina (bowelgina) as "Intermittent abdominal pain, frequently occurring at a fixed time after eating, caused by inadequacy of the mesenteric circulation. Also called intestinal angina; bowelgina."

Pathophysiology
The pathophysiology is similar to that seen in angina pectoris and intermittent claudication. The most common cause of bowelgina is atherosclerotic vascular disease, where the occlusive process commonly involves the ostia and the proximal few centimeters of the mesenteric vessels.

It can be associated with:
 * carcinoid


 * aortic coarctation


 * antiphospholipid syndrome

Frequency

 * Internationally: Extremely rare. True incidence is unknown
 * Race: No data available
 * Sex: Females outnumber males by approximately 3 to 1
 * Age: Mean age of affected individuals is slightly older than 60 years

Complete Differential Diagnosis of the causes of Abdominal angina

 * Atheroma
 * Atherosclerosis
 * Henoch-Schonlein purpura
 * Ortner's syndrome II
 * Peripheral artery occlusive disease
 * Renovascular Disease
 * Vasculitis

Complete Differential Diagnosis of the Causes of Abdominal angina
(By organ system)

Clinical

 * Hallmark of condition: Disabling midepigastric or central abdominal pain within 10-15 minutes after eating.
 * Physical examination: The abdomen typically is scaphoid and soft, even during an episode of pain. Patients present with stigmata of weight loss and signs of peripheral vascular disease, particularly aorto-iliac occlusive disease, may be present.
 * Causes: Smoking is an associated risk factor. In most series, approximately 75-80% of patients smoke.

Treatment
Stents have been used in the treatment of abdominal angina.