title: Segmental small bowel necrosis associated with antiphospholipid syndrome: a case report.
abstract: Antiphospholipid syndrome is a multi-system disease characterized by the formation of thromboembolic complications and/or pregnancy morbidity, and with persistently increased titers of antiphospholipid antibodies. We report the case of a 50-year-old, previously healthy man who presented with fever and new-onset, dull abdominal pain. A contrast-enhanced computed tomography scan showed segmental small bowel obstruction, for which an emergency laparotomy was performed. Histopathologic examination of resected tissues revealed multiple intestinal and mesenteric thromboses of small vessels. Laboratory tests for serum antiphospholipid (anticardiolipin IgM) and anti-β2-glycoprotein I antibodies were positive. Despite proactive implementation of anticoagulation, steroid, and antibiotic therapies, the patient's condition rapidly deteriorated, and he died 22 d after admission. This case highlights that antiphospholipid syndrome should be suspected in patients with unexplainable ischemic bowel and intestinal necrosis presenting with insidious clinical features that may be secondary to the disease, as early diagnosis is critical to implement timely treatments in order to ameliorate the disease course.
authors: Qun-Ying Wang, Xiao-Hua Ye, Jin Ding, Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China.
authors: Qun-Ying
authors: QY
authors: Wang
authors: Qun-Ying Wang, Xiao-Hua Ye, Jin Ding, Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China.
authors: Xiao-Hua
authors: XH
authors: Ye
authors: Qun-Ying Wang, Xiao-Hua Ye, Jin Ding, Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China.
authors: Jin
authors: J
authors: Ding
authors: Qun-Ying Wang, Xiao-Hua Ye, Jin Ding, Department of Gastroenterology and Hepatology, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua 321000, Zhejiang Province, China.
authors: Xiao-Kang
authors: XK
authors: Wu
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017152:Antibodies, Antiphospholipid / Q000097:blood; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002423:Cause of Death; D018450:Disease Progression; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D007421:Intestine, Small / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D008297:Male; D065666:Mesenteric Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis; D011237:Predictive Value of Tests; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D015415:Biomarkers; D013256:Steroids
keywords: Anticardiolipin antibodies; Antiphospholipid syndrome; Intestinal necrosis; Mesenteric arteriolar thrombosis; Small bowel obstruction