Ischemic enteritis with intestinal stenosis

Yorimitsu Koshikawa; Hiroshi Nakase; Minoru Matsuura; Takuya Yoshino; Yusuke Honzawa; Naoki Minami; Satoshi Yamada; Yumiko Yasuhara; Shigehiko Fujii; Toshihiro Kusaka; Dai Manaka; Hiroyuki Kokuryu

doi:10.5217/ir.2016.14.1.89

Intestinal Research (Jan 2016)

Ischemic enteritis with intestinal stenosis

Yorimitsu Koshikawa,
Hiroshi Nakase,
Minoru Matsuura,
Takuya Yoshino,
Yusuke Honzawa,
Naoki Minami,
Satoshi Yamada,
Yumiko Yasuhara,
Shigehiko Fujii,
Toshihiro Kusaka,
Dai Manaka,
Hiroyuki Kokuryu

Affiliations

Yorimitsu Koshikawa: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Hiroshi Nakase: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Minoru Matsuura: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Takuya Yoshino: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yusuke Honzawa: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Naoki Minami: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Satoshi Yamada: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Yumiko Yasuhara: Department of Pathology, Kyoto Katsura Hospital, Kyoto, Japan.
Shigehiko Fujii: Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan.
Toshihiro Kusaka: Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan.
Dai Manaka: Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan.
Hiroyuki Kokuryu: Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan.

DOI: https://doi.org/10.5217/ir.2016.14.1.89
Journal volume & issue: Vol. 14, no. 1
pp. 89 – 95

Abstract

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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.

Published in Intestinal Research

ISSN: 1598-9100 (Print); 2288-1956 (Online)
Publisher: Korean Association for the Study of Intestinal Diseases
Country of publisher: Korea, Republic of
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the digestive system. Gastroenterology
Website: http://www.irjournal.org

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