Tell me the diagnosis

B. Chronic mesenteric ischemia 1. Chronic mesenteric ischemia (CMI) classically presents with postprandial abdominal pain, usually beginning 15–30 minutes after eating and lasting for 1–3 hours. 2. The pain occurs because digestion increases intestinal oxygen demand, but atherosclerotic narrowing of the mesenteric arteries prevents adequate blood flow. 3. Patients gradually develop "food fear" (sitophobia) because they associate eating with severe pain, leading to reduced food intake and significant weight loss. 4. The condition most commonly affects older adults with diffuse atherosclerosis, especially those with risk factors such as smoking, diabetes, hypertension, and hyperlipidemia. 5. CT angiography (CTA) is the investigation of choice and typically demonstrates stenosis or occlusion of the celiac artery and/or superior mesenteric artery. 6. Acute cholecystitis usually causes persistent right upper quadrant pain with fever, while IBS and functional dyspepsia do not cause ischemic postprandial pain or marked weight loss. 7. Management includes risk factor modification, antiplatelet therapy, and revascularization (endovascular stenting or surgical bypass), as untreated disease can progress to acute mesenteric ischemia, a life-threatening emergency.

Very well explained

Thank you.

Give Sins some coochie.

I think restoring mesenteric blood flow would help him a lot more😅

The correct answer is: ✅ B) Chronic mesenteric ischemia Why? This patient has the classic presentation of chronic mesenteric ischemia (intestinal angina): 🍽️ Postprandial abdominal pain (typically 15–30 minutes after eating) 😣 Fear of eating (sitophobia) because meals trigger pain ⚖️ Weight loss (often develops due to reduced food intake) The pain occurs because eating increases intestinal blood flow requirements, but atherosclerotic narrowing of the mesenteric arteries prevents adequate perfusion. Why not the others? A) Irritable bowel syndrome – Pain is associated with altered bowel habits and is often relieved by defecation, not consistently triggered by meals. C) Acute cholecystitis – Causes persistent right upper quadrant pain, fever, and a positive Murphy's sign, not chronic fear of eating. D) Functional dyspepsia – Can cause meal-related discomfort, but does not typically cause severe postprandial pain leading to food avoidance or significant weight loss. Cause: Atherosclerosis involving ≥2 of the 3 major mesenteric arteries (celiac, superior mesenteric, inferior mesenteric). Classic triad: Postprandial abdominal pain Weight loss Food fear (sitophobia) Best diagnostic test: CT angiography (CTA) of the mesenteric vessels. Treatment: Revascularization (endovascular angioplasty/stenting or surgical bypass). ✅ Answer: B) Chronic mesenteric ischemia

👌👌Well explained

Thanks

Nurse name?

That’s beyond the scope of the question 😂

Send the full link to the video...it would be a great learning

porra adm....

Недоебит

Diagnosis: Genitals overuse syndrome. Treatment: He should be completely vegetarian and embrace celibacy like our current PM and become the next PM of our country. Prognosis: A guaranteed cozy and comfortable life for Mr sins. But a Disastrous future for our country.

😂😂

Post prandial abdominal pain goes with mesenteric ischemia in this case Other worthy diagnosis to be considered are Peptic ulcer disease/Gastritis Cholelithiasis Celiac disease

😂😂😂😂

🤣

Could it be gastric ulcer?

A gastric ulcer is a reasonable differential, but fear of eating due to recurrent postprandial pain is more characteristic of chronic mesenteric ischemia.

😂😂😂👀😂😂

😂

B) Chronic mesenteric ischemia Classic triad: postprandial pain (“intestinal angina”), sitophobia, and weight loss from atherosclerotic mesenteric stenosis. CTA to confirm, then revascularize before it goes acute.

Spot on

B

Correct. Classic intestinal angina after meals.

B

Correct. Classic presentation of chronic mesenteric ischemia.

When it happened

🤣🤣 Well made scenario sir 👏

Thank you, Glad you enjoyed it. 😊

😂😂😂😂😂🫢

The diagnosis gets easier once you notice the “food fear.” 😄

@Shey_phresh

Dx. He'll eat once Dharmendra Pradhan resigns.!!!

He has to die hungry

B

Exactly. “Intestinal angina” after meals is the hallmark

A

IBS usually doesn’t cause fear of eating or significant postprandial ischemic pain.

Then ???

I think it’s radiating pain from the penis

So it's STD?

Acute bacterial prostatitis + acute PTSD, as his last set involved two squirrels. He is too embarrassed to talk about it and avoids any food that has a nutty scent or flavor.

I should have started with “I’m no doctor, but…”

Chronic mesenteric Ischemia????

Yes. Postprandial pain with food fear and weight loss is the classic triad.

B

Spot on. The food fear is the key clue.

Option E.: On Hunger strike

Permanent Jantar Mantar Resident 😁

Yes sir 🙏 😀

Creo que ese señor pelón lo he visto en otro lado...

@bunnyserpentina Por favor ayudelo dra! Su prostata va estallar

B😁😁

B

Just feed him pussy and he will be just fine.

I bet in the next scene nurse restores his appetite ...

B

Chronic mesenteric ischemia