BMJ Case Reports 2013; doi:10.1136/bcr-2012-007881
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Chronic mesenteric ischaemia: a battery of negative tests in a patient with episodic abdominal pain, weight loss and diarrhoea

  1. Yasmin Pasha2
  1. 1Royal London Hospital, London, UK
  2. 2Department of Gastroenterology, Royal Free Hospital, London, UK
  1. Correspondence to Dr Amanda Kilsby, AmandaKilsby{at}


A 62-year-old woman presented with a 2-year history of abdominal pain, weight loss and diarrhoea. Her medical history included well-controlled epilepsy, migraine, hypothyroidism and depression with previous drug overdose. She was a long-term smoker. She had been referred to gastroenterology outpatients twice already by her general practitioner as suspected malignancy.

She described a 2-year history of worsening epigastric and more generalised abdominal pain that was typically postprandial and dull and ‘gnawing’ in nature. Pain was usually followed by non-bloody diarrhoea occurring up to seven times a day. She reported that pain was limiting her oral intake and over …

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