J Korean Soc Radiol.  2014 Jul;71(1):26-29. 10.3348/jksr.2014.71.1.26.

Cytomegalovirus Enteritis in an Immunocompetent Patient Causing Small Bowel Obstruction and Superior Mesenteric Artery Thrombosis: A Case Report

• Park JW
• Kim KA
• Yoon SW
• Kim DJ

• KMID: 1709017
• DOI: http://doi.org/10.3348/jksr.2014.71.1.26

Abstract

Cytomegalovirus (CMV) infection is usually associated with immunocompromised patients. The gastrointestinal (GI) tract may be affected by the CMV anywhere from the esophagus to the colon and cause GI bleeding, peritonitis or perforation. We encountered an immunocompetent patient with CMV enteritis presenting with small bowel obstruction and showing focal concentric small bowel narrowing and superior mesenteric artery (SMA) thrombosis on a post contrast enhanced CT scan. We surgically proved focal CMV enteritis. To the best of our knowledge, this is the first report on a case of CMV enteritis presenting with small bowel obstruction and SMA thrombosis complication in an immunocompetent host.

MeSH Terms

Colon
Cytomegalovirus*
Enteritis*
Esophagus
Hemorrhage
Humans
Immunocompromised Host
Mesenteric Artery, Superior*
Peritonitis
Thrombosis*
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Partial small bowel obstruction in a 51-year-old man. A. A plain abdominal radiograph shows dilatated small bowel loop with air-fluid level suggesting partial mechanical ileus. B. Small bowel follow-through shows focal luminal narrowing (white arrows) at jejunal loop and proximal bowel loop dilatation. C. Coronal reformatted post contrast enhanced CT scan shows focal concentric luminal narrowing with somewhat shouldering at small bowel (white arrow). D. Post contrast enhanced coronal reformatted CT image shows partial superior mesenteric artery thrombosis (black arrows). E. Gross specimen shows short segmental stricture at small bowel loop without ischemic change (black arrow). F. Histologic specimen shows cytomegalic cells with intranuclear inclusion (black arrows), confirmed cytomegalovirus enteritis (H&E stain, × 400).

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