Abdulrasak M, Wernehov I, Holmgren J. Chronic mesenteric ischemia diagnosed via incidental CT findings with gastroenterologist perspective: Two case reports. World J Gastrointest Pathophysiol 2025; 16(4): 112822 [PMID: 41479863 DOI: 10.4291/wjgp.v16.i4.112822]
Corresponding Author of This Article
Mohammed Abdulrasak, MD, PhD, Department of Clinical Sciences, Department of Gastroenterology and Nutrition, Lund University, Jan Waldenströms gata 14, plan 2, 205 02 Malmö, Malmo 21428, Sweden. mohammed.abdulrasak@med.lu.se
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 22, 2025 (publication date) through Jan 12, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Pathophysiology
ISSN
2150-5330
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Abdulrasak M, Wernehov I, Holmgren J. Chronic mesenteric ischemia diagnosed via incidental CT findings with gastroenterologist perspective: Two case reports. World J Gastrointest Pathophysiol 2025; 16(4): 112822 [PMID: 41479863 DOI: 10.4291/wjgp.v16.i4.112822]
World J Gastrointest Pathophysiol. Dec 22, 2025; 16(4): 112822 Published online Dec 22, 2025. doi: 10.4291/wjgp.v16.i4.112822
Chronic mesenteric ischemia diagnosed via incidental CT findings with gastroenterologist perspective: Two case reports
Mohammed Abdulrasak, Isak Wernehov, Johanna Holmgren
Mohammed Abdulrasak, Isak Wernehov, Johanna Holmgren, Department of Clinical Sciences, Department of Gastroenterology and Nutrition, Lund University, Skane University Hospital, Malmo 21428, Sweden
Author contributions: Abdulrasak M contributed to conceptualization, literature review, drafting of the manuscript, critical revisions, and final approval; Wernehov I contributed to the data collection, literature review, assistance with drafting, and critical revision of the manuscript; Holmgren H contributed to the critical review of methodology, manuscript editing, and final approval; All authors have read and approved the final version of the manuscript.
Informed consent statement: Written informed consent (attached) was obtained in Swedish from both patients for the publication of this case report and accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Abdulrasak, MD, PhD, Department of Clinical Sciences, Department of Gastroenterology and Nutrition, Lund University, Jan Waldenströms gata 14, plan 2, 205 02 Malmö, Malmo 21428, Sweden. mohammed.abdulrasak@med.lu.se
Received: August 7, 2025 Revised: September 9, 2025 Accepted: October 27, 2025 Published online: December 22, 2025 Processing time: 137 Days and 22.3 Hours
Abstract
BACKGROUND
Chronic mesenteric ischemia (CMI) is a rare but serious cause of postprandial abdominal pain and weight loss, often diagnosed late.
CASE SUMMARY
We report two cases with prolonged history of vague abdominal pain, early satiety, and significant weight loss. Extensive workups for functional and structural gastrointestinal disorders were unrevealing. The diagnosis was ultimately prompted by gastroenterologist re-review of prior computed tomography abdomen studies—performed earlier during the investigation but not specifically targeting the mesenteric vasculature. On close inspection, both scans revealed extensive vascular calcifications involving the superior mesenteric and celiac arteries, which had not been mentioned in the original radiology reports. Subsequent dedicated vascular imaging confirmed significant mesenteric artery stenosis. Both patients underwent successful endovascular intervention with complete resolution of symptoms.
CONCLUSION
These cases highlight the importance of clinician-led image review and maintaining a high index of suspicion for CMI in elderly patients with unexplained gastrointestinal symptoms presenting to the gastroenterology department.
Core Tip: Chronic mesenteric ischemia should be considered in elderly patients with unexplained postprandial pain, weight loss, and risk factors for atherosclerosis. Prompt diagnosis enables minimally invasive treatment and can prevent progression to acute mesenteric ischemia, which carries high morbidity. Clinician-led suspicion and re-review of already available imaging may aid in establishing the diagnosis with reduced delays and improved patient outcomes.
