Buerger's disease presenting as acute small bowel ischemia

Area of Science:

• Vascular Surgery
• Gastroenterology
• Internal Medicine

Background:

• Thromboangiitis obliterans (Buerger's disease) is a rare inflammatory condition affecting small and medium-sized arteries and veins, primarily in the limbs.
• It is strongly associated with tobacco use and typically presents with peripheral vascular disease, including claudication and critical limb ischemia.

Observation:

• This report details an atypical case of thromboangiitis obliterans in a young male patient.
• The initial clinical manifestation was severe ischemia of the small bowel, a highly unusual presentation for this disease.

Findings:

• The small bowel ischemia was clinically evident approximately two years prior to the development of characteristic peripheral vascular disease in the extremities.
• This temporal discrepancy in symptom presentation is a key finding, suggesting a potential for delayed diagnosis.

Implications:

• This case underscores the importance of considering thromboangiitis obliterans in young patients with unexplained gastrointestinal ischemia, even in the absence of overt limb symptoms.
• Early recognition and diagnosis are crucial for timely intervention and potentially preventing severe complications associated with both bowel and limb ischemia.