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Mesenteric vasculopathy in intestinal tuberculosis
N K Kuwajerwala1, R D Bapat, A S Joshi
1Department of General Surgery, Seth G S Medical College, Mumbai.
Background:
Involvement of mesenteric vessels in intestinal tuberculosis and its role in the pathogenesis of the intestinal changes have not been studied histologically.
Aim:
To study mesenteric vessels in patients undergoing surgery for complications of intestinal tuberculosis.
Methods:
Resected intestinal specimens from 68 patients presenting with intestinal perforation and intestinal obstruction were examined; involvement of the major mesenteric vessels was evaluated.
Results:
Granulomas were seen in the vessel wall in one case and near the vessel wall in 11 cases, intraluminal thrombi were seen in 23 cases, and subintimal fibrosis in nine cases. Perivascular cuffing was seen in intramural and subserosal vessels in ten cases.
Conclusions:
Changes in the vessel wall may lead to gut ischemia, which may contribute to the development of strictures and stercoral perforation in intestinal tuberculosis.
Insights
Histological examination of mesenteric vessels in intestinal tuberculosis revealed significant vascular changes. These alterations, including granulomas and thrombi, likely contribute to intestinal ischemia and complications like strictures and perforation.
Area of Science:
- Gastroenterology
- Vascular Pathology
- Infectious Diseases
Background:
- Mesenteric vessel involvement in intestinal tuberculosis (ITB) pathogenesis is poorly understood.
- Histological data on vascular changes in ITB is lacking.
Purpose of the Study:
- To investigate mesenteric vascular changes in patients with surgically managed complications of ITB.
Main Methods:
- Histological examination of resected intestinal specimens from 68 ITB patients.
- Evaluation focused on major mesenteric vessel involvement.
Main Results:
- Granulomas observed in/near vessel walls (12 cases).
- Intraluminal thrombi found in 23 cases.
- Subintimal fibrosis (9 cases) and perivascular cuffing (10 cases) noted.
Conclusions:
- Mesenteric vascular changes are present in ITB complications.
- These vascular alterations may cause gut ischemia, leading to strictures and perforation.