Stenosis of the Superior Mesenteric Artery.

It has been known for many years that disease of the superior mesenteric artery can produce abdominal pain and other chronic symptoms in the absence of gangrene of the bowel or peritonitis (Klein, I921; Conner, 1933; Hertzler, 1935; Seymour and Liebow, I937), and that inevitably these symptoms terminate in acute bowel infarction. However, it is only recently, as the feasibility of direct arterial surgery has become apparent, that these clinical facts have acquired new significance and more attention has been paid to the pathological background of midgut ischaemia and the nature and extent of the occlusion in the superior mesenteric artery. The chronic symptoms of midgut ischaemia have been variously referred to as 'intermittent mesenteric claudication' (Klein, 1921), 'abdominal angina' (Larson, 193I), 'abdominal claudication ' (Conner, 1933), ' mesenteric stroke' (Klass, 1953), and 'intestinal angina' (Lancet, 1958). None of these terms seems as precise or as accurate as that of' chronic midgut ischaemia.'