Acute Extensive Ischemic Enteritis in a Young Man Diagnosed with Wireless Capsule Endoscopy: A Case Report

Woo Seong Jeong; Hyun Joo Song; Soo-Young Na; Sun-Jin Boo; Heung Up Kim; Jinseok Kim; Guk Myung Choi

doi:10.4166/kjg.2013.61.3.160

Journal List > Korean J Gastroenterol > v.61(3) > 1007062

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Jeong, Song, Na, Boo, Kim, Kim, and Choi: Acute Extensive Ischemic Enteritis in a Young Man Diagnosed with Wireless Capsule Endoscopy: A Case Report

Case Report

Korean J Gastroenterol 2013;61(3):160-165.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.61.3.160

Acute Extensive Ischemic Enteritis in a Young Man Diagnosed with Wireless Capsule Endoscopy: A Case Report

Woo Seong Jeong, Hyun Joo Song, Soo-Young Na, Sun-Jin Boo, Heung Up Kim, Jinseok Kim, Guk Myung Choi¹

Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea

¹Department of Radiology, Jeju National University School of Medicine, Jeju, Korea

Correspondence to: Hyun Joo Song, Department of Internal Medicine, Jeju National University Hospital, Aran 13-gil 15, Jeju 690-767, Korea. Tel: +82-64-717-1266, Fax: +82-64-717-1131, E-mail: songhj@jejunu.ac.kr

Received 28 March 201210 June 2012 Accepted 12 June 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ischemic enteritis is caused by either the interruption or significant reduction of arterial inflow to the small intestine. Risk factors are old age, diabetes mellitus and cardiovascular disease. It is very rare in young patients. We experienced a 21-year-old man with recurrent acute ischemic enteritis who was diagnosed with capsule endoscopy. He had previously taken medications for pulmonary hypertension and obstruction of both carotid arteries, and about 20 months earlier, he had been admitted due to hematochezia. Two sessions of angiography did not reveal the cause of hematochezia. At that time, capsule endoscopy showed mucosal edema and erythema in the terminal ileum, suggesting healed ischemic enteritis. The patient was admitted again due to hematochezia. Abdominal computed tomography showed focal celiac trunk stenosis and diffuse wall thickening of the small intestine, suggesting ischemic enteritis. Capsule endoscopy showed multiple active ulcers and severe hemorrhage with exudate, extending from the proximal jejunum to the terminal ileum. Using capsule endoscopy, the patient was diagnosed with acute extensive ischemic enteritis. Because endoscopic images of ischemic enteritis have rarely been reported, we report a case of a 21-year-old man who was diagnosed acute extensive ischemic enteritis with capsule endoscopy.

Keywords: Ischemia, Enteritis, Capsule endoscopy

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Fig. 1.

Capsule endoscopic findings obtained 20 months earlier before admission. Mild mucosal edema with hyperemia in the terminal ileum (yellow arrow) suggested ischemic enteritis in the recovery phase.

Fig. 2.

Abdominal pelvic CT showing celiac trunk stenosis (A) (yellow arrow), diffuse wall thickening of the small bowel (B), which were suggestive of extensive ischemic enteritis.

Fig. 3.

Capsule endoscopy findings on admission. (A) Diffusely swollen mucosa was seen in the duodenum. (B) Active ulcers with exudates were noted in the proximal jejunum. (C, D) Severe mucosal hemorrhage with desquamation was seen, extending from the proximal jejunum to the terminal ileum.

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