Diffuse abdominal cramps after eating
Introduction
Introduction Diffuse abdominal cramps after eating are one of the symptoms of chronic mesenteric vascular insufficiency.
Cause
Cause
The cause of mesenteric arteriosclerosis caused by atherosclerosis and diabetes is more common. In addition, there are nodular arteritis, systemic lupus erythematosus, poor fibromuscular differentiation, thromboangiitis obliterans, strain granulomatous vasculitis Wegner granulomatosis.
Pathophysiology. Mainly due to the presence of three supply arteries in the abdominal viscera, namely the peritoneal, mesenteric and inferior mesenteric arteries, with collateral circulation between them. However, if the range of arteriosclerosis is extensive, when there are lesions in 2 to 3 branches, there will be insufficient blood supply, which affects the digestive function of the gastrointestinal tract and causes symptoms. Visceral arteries have fibromuscular hyperplasia, abdominal trauma or abdominal aortic aneurysm involving the abdominal cavity, mesenteric artery can also produce chronic "cold colic", but it is rare. Epidemiology. The disease occurs mostly in middle and old age, and is often accompanied by coronary arteriosclerosis, cerebral arteriosclerosis, peripheral arterial occlusive disease, and aortic aneurysm.
Examine
an examination
Related inspection
Gastric lactic acid determination of gastric sputum meal angiography CT examination
Laboratory examination: elevated white blood cell counts in peripheral blood.
Other auxiliary inspections:
1. Abdominal X-ray film and barium meal angiography, endoscopy, abdominal ultrasound and CT examination have special diagnostic significance for this disease.
2. Angiography is an important examination for the diagnosis of this disease. The abdominal aorta angiography should be performed first, and the lateral image should be emphasized to observe the position of the forward abdominal cavity and the superior mesenteric artery, and then the celiac artery. , superior mesenteric artery and inferior mesenteric artery selective angiography to observe the hardening and collateral circulation of the three main arteries in the abdomen, generally two arteries involved and the establishment of collateral circulation will produce symptoms, but should Note that angiography has the possibility of inducing acute occlusion. It should be prevented before and after angiography to correct blood concentration, vasodilator and 1 to 2 times the usual dose of anticoagulant.
Diagnosis
Differential diagnosis
Acute abdominal pain: acute abdominal pain refers to sudden pain in the abdomen of the patient. It is often caused by diseases of the abdominal or extra-abdominal organs. The former is called visceral abdominal pain, often paroxysmal with nausea and vomiting. A series of related symptoms such as sweating, abdominal pain is transmitted by the splanchnic nerve; while the latter abdominal pain is transmitted by the somatic nerves, so it is called somatic abdominal pain, which is often persistent, and is often accompanied by nausea and vomiting.
Paroxysmal abdominal pain: abdominal pain, accompanied by diarrhea, etc., symptoms are not like dysentery. Such abdominal pain and diarrhea symptoms can also be called summer paroxysmal abdominal pain. Also common in intestinal fistula, is the most common case of acute abdominal pain in children.
1. Mainly based on clinical symptoms, acute onset, abdominal cramps occur more frequently after meals, the degree of attack and duration are related to the food intake.
2. Combined with angiography, the diagnosis can be confirmed.
