Duplex Ultrasonography of the Mesenteric Circulation

Arterial occlusive disease of the celiac and superior mesenteric arteries is rare and patients with symptomatic mesenteric ischemia are encountered infrequently. However, the clinical manifestations of mesenteric arterial occlusive lesions remain enigmatic and range from asymptomatic to catastrophic. Acute occlusions of the celiac artery (CA) and the superior mesenteric artery (SMA) due to thrombosis or embolism can produce extensive, irreversible gut ischemia requiring emergency treatment, and the mortality from these events remains among the highest of all vascular emergencies. The true incidence of chronic atherosclerotic occlusive disease of the main mesenteric vessels is not well established, the precise relationship to symptoms is poorly understood, and the rate of disease progression is undocumented. It is well accepted that severe, multivessel disease may initially produce nonspecific symptoms such as pain after eating (“abdominal angina”) and weight loss—symptoms that are often mistaken for more common gastrointestinal disorders such as peptic ulcer, gallstone disease, or an occult malignancy.