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Two cases describe prolonged vague abdominal pain, early satiety, and marked weight loss, with extensive functional and structural gastrointestinal workups initially unrevealing. Diagnosis was triggered by gastroenterologist-led re-review of prior abdominal CT studies, revealing previously unreported vascular calcifications in the superior mesenteric and celiac arteries. Dedicated vascular imaging confirmed mesenteric artery stenosis, and endovascular intervention resolved symptoms. Clinician suspicion and image re-checking can reduce delays and prevent progression to acute ischemia in elderly patients.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/chronic-mesenteric-ischemia-diagnosed-via-incidental-ct-findings-with-gastroenterologist-perspective-two-case-reports/406595/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/chronic-mesenteric-ischemia-diagnosed-via-incidental-ct-findings-with-gastroenterologist-perspective-two-case-reports/406595.png","ImageObject",300,407,{"name":92,"@type":93},"Mabel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What prompted the final CMI diagnosis in these two cases?","Question",{"text":113,"@type":114},"The diagnosis was prompted by the gastroenterologist’s re-review of earlier abdominal CT scans, which revealed extensive vascular calcifications involving the superior mesenteric and celiac arteries that were not mentioned in the original reports.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What clinical symptoms were reported before CMI was diagnosed?",{"text":118,"@type":114},"Both cases had prolonged vague abdominal pain, early satiety, and significant weight loss, with additional features including diarrhea and food intolerance symptoms.",{"name":120,"@type":111,"acceptedAnswer":121},"How were the patients treated and what was the outcome?",{"text":122,"@type":114},"Subsequent dedicated vascular imaging confirmed mesenteric artery stenosis, and both patients underwent successful endovascular intervention with complete resolution of symptoms.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},406595,1790718890,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":46,"preview_page_count":4},7971474920318,"https://ap-avatar.wpscdn.com/avatar/74000ee537e6b0ca360?x-image-process=image/resize,m_fixed,w_180,h_180&k=1788430171632181674","| W | J | G | P | World Journal of\u003Cbr>Gastrointestinal Pathophysiology |\n| --- | --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastrointest Pathophysiol 2025 December 22; 16(4): 112822  \nDOI: 10.4291/wjgp.v16.i4.112822 ISSN 2150-5330 (online)  \nCASE REPORT  \nChronic mesenteric ischemia diagnosed via incidental CT findings with gastroenterologist perspective: Two case reports  \nMohammed Abdulrasak, Isak Wernehov, Johanna Holmgren  \nSpecialty type: Gastroenterology and hepatology  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade A, Grade B  \nNovelty: Grade A, Grade A  \nCreativity or Innovation: Grade B, Grade B  \nScientific Significance: Grade A, Grade C  \nP-Reviewer: Yang K, PhD,  \nAssociate Chief Physician, China  \nReceived: August 7, 2025  \nRevised: September 9, 2025  \nAccepted: October 27, 2025  \nPublished online: December 22, 2025  \nProcessing time: 137 Days and 21.7 Hours  \nMohammed Abdulrasak, Isak Wernehov, Johanna Holmgren, Department of Clinical Sciences, Department of Gastroenterology and Nutrition, Lund University, Skane University Hospital, Malmo 21428, Sweden  \nCorresponding author: Mohammed Abdulrasak, MD, PhD, Department of Clinical Sciences, Department of Gastroenterology and Nutrition, Lund University, Jan Waldenströms gata 14, plan 2, 205 02 Malmö, Malmo 21428, [Sweden.](Sweden. mohammed.abdulrasak@med.lu.se)[ mohammed.abdulrasak@med.lu.se](Sweden. mohammed.abdulrasak@med.lu.se)  \nAbstract  \nBACKGROUND  \nChronic mesenteric ischemia (CMI) is a rare but serious cause of postprandial abdominal pain and weight loss, often diagnosed late.  \nCASE SUMMARY  \nWe report two cases with prolonged history of vague abdominal pain, early satiety, and significant weight loss. Extensive workups for functional and structural gastrointestinal disorders were unrevealing. The diagnosis was ultimately prompted by gastroenterologist re-review of prior computed tomography abdomen studies—performed earlier during the investigation but not specifically targeting the mesenteric vasculature. On close inspection, both scans revealed extensive vascular calcifications involving the superior mesenteric and celiac arteries, which had not been mentioned in the original radiology reports. Subsequent dedicated vascular imaging confirmed significant mesenteric artery stenosis. Both patients underwent successful endovascular intervention with complete resolution of symptoms.  \nCONCLUSION  \nThese cases highlight the importance of clinician-led image review and maintaining a high index of suspicion for CMI in elderly patients with unexplained gastrointestinal symptoms presenting to the gastroenterology department.  \nKey Words: Chronic mesenteric ischemia; Postprandial pain; Vascular calcification; Computed tomography imaging; Diagnostic delay; Endovascular intervention; Gastrointestinal ischemia; Case report  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \n WJGP  [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 22, 2025  Volume 16  Issue 4   \nAbdulrasak M et al. Incidental CT diagnosis of CMI  \nCore Tip: Chronic mesenteric ischemia should be considered in elderly patients with unexplained postprandial pain, weight loss, and risk factors for atherosclerosis. Prompt diagnosis enables minimally invasive treatment and can prevent progression to acute mesenteric ischemia, which carries high morbidity. Clinician-led suspicion and re-review of already available imaging may aid in establishing the diagnosis with reduced delays and improved patient outcomes.  \nCitation: Abdulrasak M, Wernehov I, Holmgren J. Chronic mesenteric ischemia diagnosed via incidental CT findings with gastroenter  \nologist perspective: Two case reports. World J Gastrointest Pathophysiol 2025; 16(4): 112822  \nURL: [https://www.wjgnet.com/2150-","cbCaioDUTw12aXY1","https://ap.wps.com/l/cbCaioDUTw12aXY1","pdf",5804137,"English","# Abstract\n## Background\n## Case Summary\n## Conclusion\n# Introduction\n# Chief complaints\n# History of present illness","[{\"question\":\"What prompted the final CMI diagnosis in these two cases?\",\"answer\":\"The diagnosis was prompted by the gastroenterologist’s re-review of earlier abdominal CT scans, which revealed extensive vascular calcifications involving the superior mesenteric and celiac arteries that were not mentioned in the original reports.\"},{\"question\":\"What clinical symptoms were reported before CMI was diagnosed?\",\"answer\":\"Both cases had prolonged vague abdominal pain, early satiety, and significant weight loss, with additional features including diarrhea and food intolerance symptoms.\"},{\"question\":\"How were the patients treated and what was the outcome?\",\"answer\":\"Subsequent dedicated vascular imaging confirmed mesenteric artery stenosis, and both patients underwent successful endovascular intervention with complete resolution of symptoms.\"}]","Chronic mesenteric ischemia diagnosed via incidental CT findings with gastroenterologist perspective - Two case reports | PDF",1790566617]