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som
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08/31/06 - 05:26 PM       #1

An 83-year-old woman presents with a 1-year history of progressively severe crampy abdominal pain after eating. She has started avoiding food because of the pain. The pain is often associated with bloating, nausea, vomiting, and diarrhea. Recently, her stools have been bulky, foamy, and greasy. She has had a 15 kg (33lb) weight loss over the past year. Her other medical problems include hypertension, diabetes mellitus-type 2, hypercholesterolemia, peripheral vascular disease, coronary artery disease and myocardial infarction. Social history is not significant. Abdomen is soft, nontender and non-distended. Abdominal x-ray and CT scan are unremarkable. Which of the following is the most likely diagnosis?


A. Chronic pancreatitis

B. Atherosclerosis of the mesenteric arteries

C. Crohn' s disease

D. Irritable bowel syndrome

E. Celiac disease

F. Symptomatic cholelithiasis

G. Amyloidosis

H. Intestinal lymphoma


shalu
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08/31/06 - 05:40 PM       #2

C. Crohn' s disease

icemaiden
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08/31/06 - 05:43 PM       #3

B?

Sea_gull
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08/31/06 - 05:58 PM       #4

Atherosclerosis of mesenteric arteries = B

She is suffering from chronic mesenteric ischemia (intestinal angina).

GL


study_ing
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09/01/06 - 05:21 AM       #5

B most likely. evidence of atherosclerotic dz in history and intestinal angina.

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som
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09/01/06 - 05:37 AM       #6

yup it is B , but how do u explain the stools here?

study_ing
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09/01/06 - 05:42 AM       #7

i guess

chronic-intestinal rischemia-->impaired reabsorption


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Sea_gull
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09/01/06 - 05:51 AM       #8

som wrote:
yup it is B , but how do u explain the stools here?

If any organ suffers from chronic ischemia ,it undergoes "Ischemic atrophy" and intestine is no exception.This leads to malabsorption.









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