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Intestinal Ischemia as a Single Manifestation of Thromboangiitis Obliterans

A Case Report

Department of Rheumatology, Medical Sciences School of State University of Campinas (UNICAMP), Campinas/SP, Brazil, epmagalhaes{at}terra.com.br

Mirian Trevisan, MD, PhD

Department of Pathology, Medical Sciences School of State University of Campinas (UNICAMP), Campinas/SP, Brazil

Miki Mochizuki, MD

Department of Surgery, Medical Sciences School of State University of Campinas (UNICAMP), Campinas/SP, Brazil

Zoraida Sachetto, MD

Department of Rheumatology, Medical Sciences School of State University of Campinas (UNICAMP), Campinas/SP, Brazil

Adil Muhib Samara, MD, PhD

Department of Rheumatology, Medical Sciences School of State University of Campinas (UNICAMP), Campinas/SP, Brazil

Sandra R.M. Fernandes, MD, PhD

Department of Rheumatology, Medical Sciences School of State University of Campinas (UNICAMP), Campinas/SP, Brazil

Thromboangiitis obliterans (TAO) is an inflammatory, nonocclusive, and nonatherosclerotic vascular disease. It commonly affects arteries, veins, and surrounding neural elements and is directly related to smoking. Although distal vessels of lower and upper extremities are the most commonly involved, other vessels such as intestinal arteries can be rarely affected. The authors describe a 41-year-old white male smoker who presented with abdominal pain for 3 months and developed an acute bowel ischemia. He underwent urgent surgery, and segmental enterectomy was performed. Histopathologic findings were suggestive of TAO, showing typical involvement of small-sized veins and arteries with intact internal elastic lamina, preserved media, a local nonspecific inflammatory reaction, with new and older arterial and venous thromboses associated. Although mesenteric arteries are seldom injured by TAO, this diagnosis must be considered when the usual causes of intestinal ischemia are ruled out. In this case, even without any other clinical symptoms of TAO, this rare diagnosis could be made.

Angiology, Vol. 56, No. 6, 789-792 (2005)
DOI: 10.1177/000331970505600619


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