cardiovascular disorders
Abdominal Aortic Branch Occlusion
Symptoms and Signs of Abdominal Aortic Branch Occlusion
Clinical manifestations (eg, pain, organ failure, necrosis) result from ischemia or infarction and vary depending on the artery involved and acuity. Acute Mesenteric Ischemia causes intestinal ischemia and infarction, resulting in severe, diffuse abdominal pain typically out of proportion to the minimal physical findings. Acute occlusion of the celiac axis may cause liver or spleen infarction. Chronic mesenteric vascular insufficiency rarely causes symptoms unless both the superior mesenteric artery and celiac axis are substantially narrowed or occluded because collateral circulation between the major splanchnic trunks is extensive. Symptoms of chronic mesenteric vascular insufficiency typically occur postprandially (as intestinal angina) because digestion requires increased mesenteric blood flow; pain begins about 30 minutes to 1 hour after eating and is steady, severe, and usually periumbilical; it may be relieved by sublingualnitroglycerin. Patients become fearful of eating; weight loss, often extreme, is common. Rarely, malabsorption develops and contributes to weight loss. Patients may have an abdominal bruit, nausea, vomiting, diarrhea or constipation, and dark stools. Acute Acute renal artery occlusion causes sudden flank pain, followed by hematuria; it can be misdiagnosed as nephrolithiasis. Chronic occlusion may be asymptomatic or result in new or hard-to-control Acute occlusion of the aortic bifurcation or distal branches can cause sudden onset of pain at rest, pallor, paralysis, absence of peripheral pulses, and coldness in the legs (see Acute Peripheral Arterial Occlusion ). Chronic occlusion can cause intermittent claudication in the legs and buttocks and erectile dysfunction (Leriche syndrome). Femoral pulse are absent, and 