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Ischemic enteritis resulting from polycythemia vera.

Soichi Yagi1,2, Kiyohide Kioka3, Yurina Koizumi3

  • 1Department of Hepatology, Osaka City General Hospital, 2-13-22, Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan. t7xcipff@gmail.com.

Clinical Journal of Gastroenterology
|July 13, 2022
PubMed
Summary

Polycythemia vera, a blood disorder, can cause serious intestinal issues like ischemic enteritis and obstruction. This case highlights a rare complication of this condition, emphasizing the need for awareness in diagnosis and treatment.

Keywords:
Intestinal obstructionIschemic enteritisMyeloproliferative disordersPolycythemia vera

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Area of Science:

  • Hematology
  • Gastroenterology
  • Pathology

Background:

  • Polycythemia vera is a myeloproliferative neoplasm characterized by excessive red blood cell production.
  • It is associated with an increased risk of thrombotic events affecting various organs.

Observation:

  • A 76-year-old male presented with abdominal distention, diagnosed with portal and superior mesenteric vein thrombosis.
  • Imaging revealed small intestinal dilation and ileal caliber changes, consistent with obstruction.
  • Laboratory tests showed elevated blood counts, and JAK2 V617F mutation was positive.

Findings:

  • The patient was diagnosed with intestinal obstruction secondary to polycythemia vera-induced mesenteric thrombosis.
  • Despite conservative management, including a transnasal ileus tube, obstruction persisted.
  • Surgical resection of 30 cm of the ileum was performed due to ischemic enteritis and strictures.

Implications:

  • This case represents a rare presentation of ischemic enteritis and bowel obstruction as a complication of polycythemia vera.
  • It underscores the importance of considering polycythemia vera in patients with unexplained mesenteric thrombosis and gastrointestinal complications.
  • Early recognition and management of polycythemia vera may prevent severe gastrointestinal morbidity.