<prompt> 65 year old female presented to OPD with complaint of abdominal pain just after eating food , episodes of vomiting and diarrhea. She gave history of Coronary aery disease from last 20 years . BP - 160100 mm Hg , pulse- 80min .On abdominal examination, there is no tenderness or rigidity. What shall be the most likely diagnosis:Peptic ulcerWilkies diseaseUlcerative colitisChronic mesenteric ischemia  <response>: CHRONIC MESENTERIC ISCHEMIA MC cause - Advanced atherosclerosis of multiple mesenteric vessels Risk factors Positive family history Hypeension Smoking Hypercholesterolemia CF Post prandial abdominal pain Lasts for 15-45 min Dt ischemia of mesenteric vessels as there will be increase demand for blood after meals Diffuse crampy pain Intestinal angina intestinal claudication Fearaversion for food Weight loss Dx: Duplex scan - to assess flow in Mesenteric vessels Investigation of choice - Aoography Rx Revascularization by Balloon angioplasty or stent placement in elderly Definitive Rx - Trans aoic endaerectomy or Bypass grafting 