Bowel ischemia and infarction. Chronic and acute causes of abdominal pain.

Bowel ischemia and infarction are diseases primarily of, but not confined to, the elderly. Insidiously developing bowel ischemia may mimic more common gastrointestinal disturbances, such as peptic ulcer disease or malignancy, and go undiagnosed for long periods. Bowel infarction is a catastrophic event: Mortality rates approach 90%. Chronic intestinal ischemia may precede infarction, or infarction may occur with no warning. Laboratory and radiologic studies have minimal value in diagnosis of these disorders. A high index of suspicion must be maintained in patients complaining of abdominal pain if these diagnoses are to be made promptly.