Welcome to honey-crusted lesionโs page.
Contributor score: 0
Comments ...
Subcomments ...
honey-crusted lesion
Great explanation! There's also a slide about this in the 100 Anatomy Concepts pdf but doesn't go into as much detail as this explanation. Thanks!
+
djtallahassee
Good explanation but I think an AAA would be more likely superior mesenteric and hepatic. the SMA and IMA are more than 3 cm apart (L1 to L4ish), Triple A affecting both would be very large.
I blew this question because I saw 3cm and jumped to AAA, didnt even see it was a sclerosis thing. Put the two closest arteries and moved on
+
The presentation here seems to fit that of mesenteric vascular occlusion- postprandial pain that lasts 1 hour, food aversion, weight loss. The patient also has risk factors associated with mesenteric vascular occlusion- older than 60 years old, Hyperlipidemia, Hypertension, PMHx.
"The mesenteric circulation consists of three primary vessels that supply blood to the small and large bowel: the celiac artery, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA). Blood flow through these arteries increases within an hour after eating due to an increase in metabolic demand of the intestinal mucosa.Chronic occlusion of a single vessel allows collateral blood flow to compensate, thus symptoms do not typically present until at least two primary vessels are occluded." https://www.ncbi.nlm.nih.gov/books/NBK430748/
Collaterals between SMA and IMA near the splenic flexure (Meandering Mesenteric artery). There is also collateral between Celiac Artery and SMA (Pancreaticoduodenal arcade).
Lastly, I know that there is a 3-cm ectatic aorta found on CT, but an aortic aneurysm would not produce these symptoms. Even if you thought that the symptoms were due to the AAA, you could still get to the correct answer if you use fahmed14's reasoning.