Intestinal ischemia as the first manifestation of vasculitis.
OBJECTIVE
To summarize current knowledge regarding the diagnosis and management of gastrointestinal vasculitis.


METHODS
Three cases of gastrointestinal vasculitis with acute abdominal ischemia as their first manifestation are presented. Underlying diseases were microscopic polyangiitis, systemic lupus erythematosus (SLE), and polyarteritis nodosa (PAN). Relevant English-language articles collected from the PubMed database were reviewed.


RESULTS
Among the angiitides, PAN, SLE, and Henoch-Schönlein are those most commonly accompanied by gastrointestinal complications. Intestinal vasculitis usually occurs when there is evidence of generalized disease activity. Abdominal computerized tomography is a valuable tool for diagnosing intestinal ischemia and suspected vasculitis.


CONCLUSIONS
In young patients presenting with intestinal ischemia, it is essential to assess the possibility of an underlying systemic disease. With prompt initiation of immunosuppressive treatment, surgery may be avoided. Prognosis is improved when there is minimal delay in surgical intervention.
Division of Internal Medicine, University Hospital of Crete, Heraklion, Greece.
Freda H
FH
Passam
Ioannis D
ID
Diamantis
Garyfalia
G
Perisinaki
Zenia
Z
Saridaki
Herakles
H
Kritikos
Dimitrios
D
Georgopoulos
Dimitrios T
DT
Boumpas
D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology; D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000175:diagnosis*; D007813:Laparotomy; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000175:diagnosis; D018570:Risk Assessment; D014657:Vasculitis / Q000175:diagnosis*