Dramatic unintentional weight loss can be caused by a spectrum of diseases ranging from very serious to benign and treatable. We describe the case of a 70-year-old woman with an extensive history of cardiovascular disease who presented with unintentional weight loss. Although she was diagnosed and treated for colitis, the patient continued to lose 50 pounds over 8 months, which prompted an angiogram. The angiogram revealed occlusion of her superior and inferior mesenteric arteries just distal to their origins, together with high-grade (80%-90%) stenosis at the origin of the celiac axis. After a stent was placed in the ostium of the celiac axis, the patient immediately began to regain weight. We suggest that clinicians consider chronic mesenteric ischemia when treating patients with undiagnosed unintentional weight loss and a history of atherosclerotic disease.
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