EVALUATION OF INTRA-ABDOMINAL DISEASE OF OBSCURE CAUSE

Unexplained chronic abdominal pain poses a vexing problem in patient management. When the clinical examination and radiologic and laboratory studies are uninformative, the physician is confronted with a dilemma. Should he watch the patient until the disease process advances sufficiently to produce objective evidence for diagnosis, or should a surgical exploration of the abdomen be advised to establish the diagnosis? Since such an exploration would be based upon subjective evaluation of the patient's symptoms, the possibility of an unrewarding laparotomy often prompts a course of "watchful waiting."

In the last few years, several reports have appeared in the literature concerning the diagnostic use of selective angiography of branches of the abdominal aorta which supply gastrointestinal structures.¹ This procedure has two goals. The first is for the detection of primary arterial occlusive disease which might be the cause of so-called abdominal angina. The second is to determine if there are