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BMJ Case Reports 2009; doi:10.1136/bcr.07.2008.0501
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Diarrhoea caused by a stenosis of the coeliac artery: suggestive for mesenteric steal

  1. Désirée van Noord1,
  2. Peter B Mensink1,
  3. Pieter C ter Borg1,
  4. Peter M Pattynama2,
  5. Hence J Verhagen3,
  6. Ernst J Kuipers4
  1. 1
    Erasmus MC - University Medical Center, Gastroenterology and Hepatology, Gravendijkwal 230, Rotterdam, 3015 CE, Netherlands
  2. 2
    Erasmus MC - University Medical Center, Intervention Radiology, Gravendijkwal 230, Rotterdam, 3015 CE, Netherlands
  3. 3
    Erasmus MC - University Medical Center, Vascular Surgery, Gravendijkwal 230, Rotterdam, 3015 CE, Netherlands
  4. 4
    Erasmus MC University Medical Center, PO Box 2040, Rotterdam, 3000CA, Netherlands
  1. Désirée van Noord, d.vannoord{at}erasmusmc.nl
  • Published 5 March 2009

Summary

The classical triad of postprandial pain, weight loss and an abdominal bruit is thought to be the most common presentation of chronic gastrointestinal ischaemia. We describe a patient with severe diarrhoea as an uncommon presenting symptom of small bowel ischaemia, suggesting a mesenteric steal phenomenon due to a significant atherosclerotic coeliac artery stenosis. The stenosis and concomitant steal effect was successfully treated by stent placement. The latter is supported by the patient’s uneventful course after stent placement. This case illustrates that chronic gastrointestinal ischaemia has to be considered in patients with otherwise unexplained diarrhoea.

Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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