Angiographic diagnosis of mesenteric arterial vasoconstriction

Experimental mesenteric arterial vasoconstriction (MAV) is characterized by narrowings at the origins of multiple branches of the superior mesenteric artery, irregularities in intestinal branches, spasm of arcades, and impaired filling of intramural vessels. None of these findings occurred in a control group of patients without MAV. MAV may be diffuse or localized and reversible or irreversible. Reversible MAV decreases after test infusion of papaverine, and responds to therapeutic infusion of 30-60 mg of papaverine per hr for 16 to 24 hr. Several case studies are presented. Early diagnosis of reversible MAV is important to prevent irreversible bowel changes.