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Abstract
We examined 60 patients with CP associated with abdominal ischemic syndrome, aged from 55 to 72. The medium severity index (MSI) was used to evaluate the degree of clinical manifestations. Patients underwent color Doppler mapping: blood flow in the abdominal aorta, celiac trunk, and superior mesenteric artery was assessed.
According to the features of CP clinical manifestations, patients were divided into two groups. 18 patients in Group 1 exhibited pain syndrome dominating the clinical picture. 42 patients in Group 2 exhibited symptoms of functional pancreatic insufficiency dominating the clinical picture.
The MSI for pain syndrome in patients in Group 1 was 2.38. Notably, apart from its severity, the pain varied in that its degree was more influenced by the amount of food than by its quality. Low-intensity pain was observed in Group 2 patients; their MSI was just 1.42.
Patients in Group 1 had moderately expressed dyspeptic symptoms, with an MSI of 1.82. The main complaints were nausea, unstable stools, and flatulence. Two patients had vomiting, which did not bring relief. The MSI of dyspeptic symptoms in Group 2 was higher than in Group 1 and amounted to 2.12. More often, patients reported bloating, rumbling in the abdomen, particularly after eating, loose stools, and prolonged exhausting nausea.
Clinical manifestations of exocrine pancreatic insufficiency dominated the CP clinical picture among patients in Group 2 (MSI reached 2.44). Patients in Group 1 also had moderately severe clinical manifestations of pancreatic insufficiency, with an MSI of 1.74. Four patients in this group had pancreatogenic diabetes.
There are two different types of clinical manifestations among people with CP and abdominal ischemic syndrome. In the first option, severe pain syndrome often manifests as clearly defined attacks that coincide with angina pectoris attacks or blood pressure spikes and are treated with nitroglycerin. In the second option, symptoms of both exocrine and endocrine pancreatic insufficiency predominate, while the pain syndrome is much less intense, longer lasting, and rarely relieved by nitroglycerin.
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