Korean J Gastroenterol.  2013 Apr;61(4):234-236. 10.4166/kjg.2013.61.4.234.

Severe Mesenteric Hemorrhagic Infarction by Superior Mesenteric Arterial Occlusion in a Patient with Buerger's Disease

• Ok KS
• Kim YS
• Hong SW
• Lee HK

• KMID: 1775765
• DOI: http://doi.org/10.4166/kjg.2013.61.4.234

Abstract

No abstract available.

MeSH Terms

Arterial Occlusive Diseases/complications/*diagnosis/radiography
Hemorrhage
Humans
Ileal Diseases/radiography/surgery
Ileocecal Valve/blood supply
Infarction/pathology/*surgery
Male
Mesenteric Artery, Superior/*radiography
Middle Aged
Thromboangiitis Obliterans/complications/*diagnosis
Tomography, X-Ray Computed

Figure

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  Fig. 1. The inferior branch of the superior mesenteric artery was obstructed completely by thrombus (A). Enhanced thin wall (narrow arrow) was seen at the antimesenteric border of distal ileum, but the mesenteric border (broad arrow) of the distal ileum was not seen (B).

• 

  Fig. 2. Extensive transmural hemorrhagic infarction involving the distal ileum (red arrow), terminal ileum and cecum was noted. Gangrenous necrosis was also seen at the terminal ileum (yellow arrow).

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  Fig. 3. Microscopic findings. (A) Scanning photomicrography of the terminal ileum revealed transmural hemorrhagic infarct with extensive mucosal ulceration and submucosal hemorrhage (H&E, ×100). (B) Thromboangiitis obliterans with multiple fibrin thrombi (arrows) was diagnosed with near total occluding vascular lumina of the submucosa (H&E, ×200).

Reference

References

1. Olin JW, Young JR, Graor RA, Ruschhaupt WF, Bartholomew JR. The changing clinical spectrum of thromboangiitis obliterans (Buerger's disease). Circulation. 1990; 82(5 Suppl):IV3–IV8.

2. Papa MZ, Adar R. A critical look at thromboangiitis obliterans (Buerger's disease). Perspect Vasc Surg Endovasc Ther. 1992; 5:1–18.

3. Lazarides MK, Georgiadis GS, Papas TT, Nikolopoulos ES. Diagnostic criteria and treatment of Buerger's disease: a review. Int J Low Extrem Wounds. 2006; 5:89–95.

4. Hassoun Z, Lacrosse M, De Ronde T. Intestinal involvement in Buerger's disease. J Clin Gastroenterol. 2001; 32:85–89.

5. Kobayashi M, Kurose K, Kobata T, Hida K, Sakamoto S, Matsu-bara J. Ischemic intestinal involvement in a patient with Buerger disease: case report and literature review. J Vasc Surg. 2003; 38:170–174.

6. Sauvaget F, Debray M, Hervéde Sigalony JP, et al. Colonic ischemia reveals thromboangiitis obliterans (Buerger's disease). Gastroenterology. 1996; 110:900–903.

7. Krupski WC, Selzman CH, Whitehill TA. Unusual causes of mesenteric ischemia. Surg Clin North Am. 1997; 77:471–502.

8. Shionoya S. Diagnostic criteria of Buerger's disease. Int J Cardiol. 1998; 66(Suppl 1):S243–S245.

9. Leu HJ. Early inflammatory changes in thromboangiitis obliterans. Pathol Microbiol (Basel). 1975; 43:151–156.

10. Olin JW, Lie JT. Thromboangiitis obliterans (Buerger's disease). Loscalzo J, Creager MA, Dzau VJ, editors. Vascular medicine. 2nd ed.Boston: Little, Brown;1996. p. 1033–1049.

11. Raat H, Stockx L, Broeckaert L, et al. Mesenteric involvement of thromboangiitis obliterans (Buerger's disease) in a woman. J Belge Radiol. 1993; 76:245–246.

12. Cordobès Gual J, Riera Vázquez R, Merino Mairal O, Manuel- Rimbau Muñoz E, Lozano Vilardell P, Company Campins M. Buerger's disease with intestinal ischemic involvement. An Med Interna. 2005; 22:235–237.