Intestinal ischemia is caused by a reduction in blood flow to a level that is insufficient for the delivery of oxygen and nutrients required for cellular metabolism. It is often related to acute arterial occlusion (embolic or thrombotic), venous thrombosis, or hypoperfusion of the mesenteric vasculature causing a non-occlusive ischemia or vasoconstriction. Acute intestinal ischemia due to severe hyperplasia of the intima of mesocolic/mesenteric small arteries consistent with fibromuscular dysplasia (FMD) has not been previously described. We report the case of a 47-year-old otherwise healthy male who presented with an acute abdomen with negative computed tomography angiogram but ischemic enterocolitis with necrosis due to severe intimal thickening of the mesenteric/mesocolic small arteries resembling the pattern of FMD.
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