Segmental xanthomatosis of the ileocecal valve with anatomic and functional obstruction

A case of intestinal obstruction due to segmental xanthomatosis involving the small intestine and colon at the ileocecal valve is described in a patient with acquired immunodeficiency syndrome. Infiltration of the bowel wall with lipid-laden histiocytes is documented and is associated with severe attenuation and disruption of the muscularis propria. This xanthomatous infiltrate resulted in luminal stenosis and dysfunctional motility. Segmental xanthomatosis of the bowel is a rare cause of intestinal obstruction due to an infiltrative process. The clinical, radiologic, and pathologic presentation of xanthomatosis may mimic other causes of bowel obstruction.