Gut Liver.  2010 Jun;4(2):287-291.

Colon Ischemia Associated with Buerger's Disease: Case Report and Review of the Literature

• Lee KS
• Paik CN
• Chung WC
• Lee KM
• Jung SH
• Kawk JW
• Jung JH
• Baik JH

Abstract

Buerger's disease, or thromboangiitis obliterans, is a nonatherosclerotic inflammatory disease affecting the small- and medium-sized arteries and veins of the extremities (arms, hands, legs, and feet). It is most common in the Orient, Southeast Asia, India, and the Middle East, and usually affects men aged between 20 and 40 years, although it is becoming more common in women. It is well established that most such patients smoke heavily and experience an improvement in symptoms following smoking cessation. Mesenteric involvement in Buerger's disease is extremely rare; however, we describe herein two cases of colon ischemia in patients who were previously diagnosed with lower-extremity Buerger's disease. In one case, the patient developed colonic obstruction, and surgical resection was performed. Histopathologic findings were compatible with the chronic stage of Buerger's disease. In the other case, angiography revealed abrupt occlusion of the inferior mesenteric artery with numerous collateral vessels, just like the corkscrew appearance found in the extremities. If patients with established Buerger's disease of the extremities complain of gastrointestinal symptoms, early interventional diagnosis should be performed to prevent intestinal obstruction and gangrene.

Keyword

Thromboangiitis obliterans; Mesenteric involvement; Colon ischemia

MeSH Terms

Aged
Angiography
Arteries
Asia, Southeastern
Colon
Extremities
Female
Gangrene
Hand
Humans
India
Intestinal Obstruction
Ischemia
Leg
Male
Mesenteric Artery, Inferior
Middle East
Smoke
Smoking Cessation
Thromboangiitis Obliterans
Veins
Smoke