Pathological Study on Characteristic of Intestinal Ulcer of Periarteritis Nodosa Shigekazu Kuroiwa 1 1Department of Pathology, Hamanomachi Hospital Keyword: 壊死性血管炎 , 結節性動脈周囲炎 , 腸潰瘍 , 虚血性腸疾患 , 動脈瘤 pp.1257-1265
Published Date 1991/11/25
DOI https://doi.org/10.11477/mf.1403102687
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 Bowels of 7 cases of periarteritis nodosa accompanied with vasculitis were studied clinicopathologically. In two cases, the bowels were surgically resected. In five cases they were necropsied. All of the seven cases had some lesions including ulcers, erosions, necrosis, hematomas, aneurysms etc in their bowel walls. Six cases revealed ulcers in the small bowel showing the following characteristics. These ulcers (1) were multiple and separated by mildly edematous or almost normal mucosa,(2) had a tendency to be located at the antimesenteric border,(3) were predominantly irregular in shape and frequently extended toward the mesenteric border to form subannular or annular ulcers, when they were wider at the antimesenteric border than at the mesenteric border,(4) were less than 3 cm in width along the long axis of the bowel, and (5) were shallow.

 Histopathologically these ulcers showed essentially the same features as in ischemic enterocolitis. Necrotizing arteritis in the acute inflammatory or granulationtissue stage was encountered in the bowel walls or in the mesenteric fat near the ulcers except for one case with arteritis in a healed stage, who had been treated with steroids for a month. In three autopsy cases more than two dome-shaped small submucosal nodules made up of aneurysms were scattered. According to the results obtained, macroscopic characteristics, causative factors and differential diagnosis of ulcer in the bowel of patients with periarteritis nodosa were briefly discussed, and the ulcers of earlier Japanese reported cases were reviewed.

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