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Acute small bowel ischemia without transmural infarction.

G E Feurle1, B Haag

  • 1I. Medizinische Abteilung, Stadtkrankenhaus Neuwied, Bundesrepublik Deutschland.

Zeitschrift Fur Gastroenterologie
|July 1, 1991
PubMed
Summary

Acute mesenteric ischemia can cause "regional enteritis" in the small bowel, mimicking Crohn's disease radiologically. This condition, similar to ischemic colitis, highlights a distinct clinical entity from arterial embolism.

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Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Radiology

Background:

  • Atrial fibrillation is a common cardiac arrhythmia associated with an increased risk of embolic events.
  • Mesenteric artery embolism can lead to acute intestinal ischemia, presenting with abdominal pain and bowel distension.
  • Distinguishing ischemic enteritis from other causes of small bowel inflammation is crucial for appropriate management.

Observation:

  • Two patients with atrial fibrillation presented with acute abdominal pain and massive small bowel distension, suggestive of mesenteric artery embolism.
  • Both patients were managed conservatively with gradual recovery.
  • Follow-up small bowel imaging revealed mucosal abnormalities and stenosis, resembling features of Crohn's disease.

Findings:

  • Acute mesenteric ischemia can induce a clinical syndrome of "regional enteritis" in the small bowel.
  • Radiological features of ischemic small bowel enteritis may mimic Crohn's disease.
  • This entity is analogous to the well-recognized condition of ischemic colitis.

Implications:

  • Recognition of acute ischemic small bowel enteritis is important to avoid misdiagnosis, particularly with Crohn's disease.
  • Understanding the long-term radiological changes following mesenteric ischemia is essential.
  • Conservative management may be effective for select cases of acute ischemic enteritis.

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