A Case of Ischemic Duodenal and Jejunal Enteritis in a Patient with Chronic Splanchnic Disease.
- Author:
Gun Min KIM
1
;
Yong Cheol KIM
;
Jin Min PARK
;
Seok In HONG
;
Jin Il KIM
;
Soo Heon PARK
;
Jae Kwang KIM
Author Information
1. Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. psheon5132@naver.com
- Publication Type:Case Report
- Keywords:
Splanchnic circulation;
Ischemia;
Duodenitis
- MeSH:
Abdomen;
Angiography;
Arteries;
Atrial Fibrillation;
Collateral Circulation;
Constriction, Pathologic;
Duodenitis;
Duodenum;
Edema;
Electrocardiography;
Endoscopy, Digestive System;
Enteritis;
Erythema;
Female;
Fluid Therapy;
Follow-Up Studies;
Hematemesis;
Hemorrhage;
Humans;
Ischemia;
Jejunum;
Mesenteric Artery, Superior;
Mucous Membrane;
Splanchnic Circulation;
Thrombosis;
Upper Gastrointestinal Tract;
Vasoconstriction;
Vomiting
- From:Korean Journal of Medicine
2012;82(6):704-708
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Gastrointestinal ischemia happens by splanchnic artery stenosis, thrombus, or physiological vasoconstriction during a low-blood-stream state. However, even if arterial stenosis exists in the upper gastrointestinal tract, ischemic injury is very rare due to rich collateral circulation. The authors experienced 92-year-old female patient with vomiting, epigastric pain, and hematemesis. An electrocardiogram showed paroxysmal atrial fibrillation. The patient had diffuse and segmental mucosal edema, erythema, and hemorrhage in the second part of the duodenum on esophagogastroduodenoscopy (EGD). On abdomen computed-tomography angiography, stenosis of the celiac and superior mesenteric arteries was observed, and segmental concentric wall thickness was seen from the proximal second portion of the duodenum to the proximal jejunum. The patient was treated with PPI and fluid therapy for one week. At follow-up EGD, the mucosa had improved compared with the previous EGD examination. In conclusion, ischemic injury rarely affects the duodenum and jejunum; however, it can develop in the presence of inducing factors.
