Recurrent Stenosis of the Ileum Caused by Rheumatoid Vasculitis

Tago, Masaki; Naito, Yuka; Aihara, Hiroki; Furukawa, Naoko; Yamashita, Shizuya

doi:10.2169/internalmedicine.55.5791

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…In many cases of elderly patients, small bowel stenosis is caused by neoplastic lesion such as carcinomas and lymphomas. Ischemic enteritis, rheumatoid vasculitis, and diaphragm disease have been reported as the rare causes of small bowel stenosis [4,[14][15][16]. In previous reports, most elderly patients with stenotic ischemic enteritis have underlying diseases including hypertension, diabetes mellitus, atrial fibrillation, cerebral infarction, and ischemic heart disease [4,14].…”

Section: Discussionmentioning

confidence: 99%

Smooth muscle degeneration of the mesenteric and branching veins causing ischemic enteritis: a case report

et al. 2022

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Background Ischemic bowel injuries are generally caused by arteriosclerosis, thromboembolism, or vasculitis. Ischemic enteritis is less common than ischemic colitis because of the rich collateral arteries of the small intestine. In the present case, smooth muscle degeneration of the mesenteric to the submucosal veins caused ischemic enteritis and small bowel obstruction. Case presentation An 85-year-old woman with recurrent enteritis eventually developed small bowel obstruction. We performed laparoscopic partial resection of the small intestine. The pathological findings revealed smooth muscle degeneration of the mesenteric veins that caused ischemic enteritis. Venous changes were detected not only in the injured region, but also in a part of the normal region of the resected specimen. She continued to experience some minor symptoms postoperatively; however, these symptoms subsided in a short period with medicine discontinuation. Conclusion This report shows the possibility that a disease causes ischemic enteritis with unique venous pathological changes and may recur postoperatively.

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Section: Discussionmentioning

confidence: 99%

Smooth muscle degeneration of the mesenteric and branching veins causing ischemic enteritis: a case report

et al. 2022

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“…GI manifestations may develop in 10–38% of patients with rheumatoid arthritis-associated vasculitis. These presentations include segmental or extensive intestinal infarction, ileal stricture [ 121 , 122 ], ischemic ulcers of the intestine, and bowel perforation. Rarely other extra-intestinal findings, including hepatomegaly, intrahepatic hemorrhage, and pancreatic necrosis, can be evident [ 123 ].…”

Section: Vasculitis Associated With Systemic Diseasesmentioning

confidence: 99%

Imaging of intestinal vasculitis focusing on MR and CT enterography: a two-way street between radiologic findings and clinical data

et al. 2022

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Diagnosis of intestinal vasculitis is often challenging due to the non-specific clinical and imaging findings. Vasculitides with gastrointestinal (GI) manifestations are rare, but their diagnosis holds immense significance as late or missed recognition can result in high mortality rates. Given the resemblance of radiologic findings with some other entities, GI vasculitis is often overlooked on small bowel studies done using computed tomography/magnetic resonance enterography (CTE/MRE). Hereon, we reviewed radiologic findings of vasculitis with gastrointestinal involvement on CTE and MRE. The variety of findings on MRE/CTE depend upon the size of the involved vessels. Signs of intestinal ischemia, e.g., mural thickening, submucosal edema, mural hyperenhancement, and restricted diffusion on diffusion-weighted imaging, are common in intestinal vasculitis. Involvement of the abdominal aorta and the major visceral arteries is presented as concentric mural thickening, transmural calcification, luminal stenosis, occlusion, aneurysmal changes, and collateral vessels. Such findings can be observed particularly in large- and medium-vessel vasculitis. The presence of extra-intestinal findings, including within the liver, kidneys, or spleen in the form of focal areas of infarction or heterogeneous enhancement due to microvascular involvement, can be another radiologic clue in diagnosis of vasculitis. The link between the clinical/laboratory findings and MRE/CTE abnormalities needs to be corresponded when it comes to the diagnosis of intestinal vasculitis.

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“…47,48 One case presented with recurrent ileal strictures, which may mimic Crohn’s disease. 49 Within the pancreas, early reports described pancreatic necrosis secondary to medium vessel vasculitis. 37 Intrahepatic hemorrhage, hepatic capsule rupture, and abdominal aneurysmal rupture with syncope have all been described.…”

Section: The Gi Tract In Ra Pathogenesismentioning

confidence: 99%

Gastrointestinal and Hepatic Disease in Rheumatoid Arthritis

Craig

Cappelli

2018

Rheumatic Disease Clinics of North America

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Gastrointestinal (GI) manifestations of rheumatoid arthritis (RA) are rare, but can be impactful for patients. Some GI processes are directly related to RA, whereas others may be sequelae of treatment or caused by concomitant autoimmune diseases. This article discusses the role of the GI tract in RA pathogenesis; the presentation, epidemiology, and diagnosis of RA-related GI manifestations; concomitant GI autoimmune diseases that may affect those with RA; and GI side effects of RA treatment. The importance of appropriately considering conditions unrelated to RA in the differential diagnosis when evaluating new GI symptoms in patients with RA is noted.

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Recurrent Stenosis of the Ileum Caused by Rheumatoid Vasculitis

Cited by 5 publications

References 12 publications

Smooth muscle degeneration of the mesenteric and branching veins causing ischemic enteritis: a case report

Smooth muscle degeneration of the mesenteric and branching veins causing ischemic enteritis: a case report

Imaging of intestinal vasculitis focusing on MR and CT enterography: a two-way street between radiologic findings and clinical data

Gastrointestinal and Hepatic Disease in Rheumatoid Arthritis

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