Diagnosis of chronic intestinal ischemia

The diagnosis of CII continues to be made primarily on a clinical basis. While CII secondary to atherosclerosis of the major splanchnic vessels is a well-recognized clinical entity, symptomatic celiac compression syndrome must be regarded as controversial with an uncertain pathophysiologic basis. Tests of intestinal absorption and excretion have not proven useful in confirming the diagnosis of CII. Angiography is mandatory in cofirming the presence of appropriate splanchnic artery lesions in patients with suspected CII. Preliminary data suggest ultrasonic duplex scanning may be a useful screening tool in selected patients before angiography, but further prospective analysis is required before widespread clinical application of this mode of testing is appropriate.