Korean J Med.  2012 Jun;82(6):704-708.

A Case of Ischemic Duodenal and Jejunal Enteritis in a Patient with Chronic Splanchnic Disease

• Kim GM
• Kim YC
• Park JM
• Hong SI
• Kim JI
• Park SH
• Kim JK

Abstract

Gastrointestinal ischemia happens by splanchnic artery stenosis, thrombus, or physiological vasoconstriction during a low-blood-stream state. However, even if arterial stenosis exists in the upper gastrointestinal tract, ischemic injury is very rare due to rich collateral circulation. The authors experienced 92-year-old female patient with vomiting, epigastric pain, and hematemesis. An electrocardiogram showed paroxysmal atrial fibrillation. The patient had diffuse and segmental mucosal edema, erythema, and hemorrhage in the second part of the duodenum on esophagogastroduodenoscopy (EGD). On abdomen computed-tomography angiography, stenosis of the celiac and superior mesenteric arteries was observed, and segmental concentric wall thickness was seen from the proximal second portion of the duodenum to the proximal jejunum. The patient was treated with PPI and fluid therapy for one week. At follow-up EGD, the mucosa had improved compared with the previous EGD examination. In conclusion, ischemic injury rarely affects the duodenum and jejunum; however, it can develop in the presence of inducing factors.

Keyword

Splanchnic circulation; Ischemia; Duodenitis

MeSH Terms

Abdomen
Angiography
Arteries
Atrial Fibrillation
Collateral Circulation
Constriction, Pathologic
Duodenitis
Duodenum
Edema
Electrocardiography
Endoscopy, Digestive System
Enteritis
Erythema
Female
Fluid Therapy
Follow-Up Studies
Hematemesis
Hemorrhage
Humans
Ischemia
Jejunum
Mesenteric Artery, Superior
Mucous Membrane
Splanchnic Circulation
Thrombosis
Upper Gastrointestinal Tract
Vasoconstriction
Vomiting