title: Ischemic enteritis with intestinal stenosis.
abstract: A 75-year-old man was admitted to our hospital with sudden onset of vomiting and abdominal distension. The patient was taking medication for arrhythmia. Computed tomography showed stenosis of the ileum and a small bowel dilatation on the oral side from the region of stenosis. A transnasal ileus tube was placed. Enteroclysis using contrast medium revealed an approximately 6-cm afferent tubular stenosis 10 cm from the terminal ileum and thumbprinting in the proximal bowel. Transanal double-balloon enteroscopy showed a circumferential shallow ulcer with a smooth margin and edema of the surrounding mucosa. The stenosis was so extensive that we could not perform endoscopic balloon dilation therapy. During hospitalization, the patient's nutritional status deteriorated. In response, we surgically resected the region of stenosis. Histologic examination revealed disappearance of the mucosal layer and transmural ulceration with marked fibrosis, especially in the submucosal layer. Hemosiderin staining revealed sideroferous cells in the submucosal layers. Based on the pathologic findings, the patient was diagnosed with ischemic enteritis. The patient's postoperative course was uneventful.
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Yorimitsu
authors.initials: Y
authors.lastname: Koshikawa
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakase
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Matsuura
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Yoshino
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Honzawa
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Minami
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Pathology, Kyoto Katsura Hospital, Kyoto, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Yasuhara
authors.affiliation: Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan.
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Fujii
authors.affiliation: Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kusaka
authors.affiliation: Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Manaka
authors.affiliation: Digestive Disease Center, Kyoto Katsura Hospital, Kyoto, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kokuryu
keywords: Double-balloon enteroscopy; Intestines; Ischemia; Stenosis