Gastrointestinal vasculitis and vasculitis associated with gastrointestinal diseases

Vasculitis and the gut may be linked in two different sets of circumstances. In one, which is more common, the gut is merely one of the several organ-systems affected by systemic vasculitis and vasculitis associated with rheumatic connective tissue diseases or inflammatory bowel disease (secondary vasculitis). In the other, which is more uncommon, the vasculitis is isolated to the gastrointestinal tract (primary vasculitis). In either category, intestinal ischemia with hemorrhage, perforation, or gangrene may be the catastrophic complications that, even with timely surgical intervention, could still carry a high mortality rate. Familiarity with the histopathologic spectrum of primary and secondary gastrointestinal vasculitis is a prerequisite for correct interpretation of biopsy and surgical resection specimens that will determine the appropriate choice of treatment.