Intest Res.  2016 Jan;14(1):89-95. 10.5217/ir.2016.14.1.89.

Ischemic enteritis with intestinal stenosis

Affiliations
  • 1Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. hiropy_n@kuhp.kyoto-u.ac.jp
  • 2Department of Pathology, Kyoto Katsura Hospital, Kyoto, Japan.
  • 3Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan.

Abstract

A 75-year-old man was admitted to our hospital with sudden onset of vomiting and abdominal distension. The patient was taking medication for arrhythmia. Computed tomography showed stenosis of the ileum and a small bowel dilatation on the oral side from the region of stenosis. A transnasal ileus tube was placed. Enteroclysis using contrast medium revealed an approximately 6-cm afferent tubular stenosis 10 cm from the terminal ileum and thumbprinting in the proximal bowel. Transanal double-balloon enteroscopy showed a circumferential shallow ulcer with a smooth margin and edema of the surrounding mucosa. The stenosis was so extensive that we could not perform endoscopic balloon dilation therapy. During hospitalization, the patient's nutritional status deteriorated. In response, we surgically resected the region of stenosis. Histologic examination revealed disappearance of the mucosal layer and transmural ulceration with marked fibrosis, especially in the submucosal layer. Hemosiderin staining revealed sideroferous cells in the submucosal layers. Based on the pathologic findings, the patient was diagnosed with ischemic enteritis. The patient's postoperative course was uneventful.

Keyword

Ischemia; Intestines; Stenosis; Double-balloon enteroscopy

MeSH Terms

Aged
Arrhythmias, Cardiac
Constriction, Pathologic*
Dilatation
Double-Balloon Enteroscopy
Edema
Enteritis*
Fibrosis
Hemosiderin
Hospitalization
Humans
Ileum
Ileus
Intestines
Ischemia
Mucous Membrane
Nutritional Status
Ulcer
Vomiting
Hemosiderin
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