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Endoscopic Findings in Duodenum of Systemic Vasculitis Patients Susumu Hara 1 , Mitsunori Noguchi 1 , Masaaki Yamaguchi 2 , Akira Imatani 3 , Shuichi Ohara 3 1Department of Gastroenterology, Sendai Shakaihoken Hospital 2Department of Pathology, Sendai Shakaihoken Hospital 3Division of Gastroenterology, Tohoku University Graduate School of Medicine Keyword: 結節性多発動脈炎 , 血管炎症候群 , 十二指腸びらん pp.801-808
Published Date 2002/5/25
DOI https://doi.org/10.11477/mf.1403103529
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 We investigated endoscopic findings of the duodenum in patients with systemic vasculitis. Out of 37 patients with systemic vasculitis, duodenal lesions were found to be affected in 9 patients. Nine patients, comprised of 2 patients with polyarteritis nodosa, 2 with microscopic polyarteritis and one each with Henoch-Schönlein purpura, Rheumatoid arthritis, Wegener, Dermatomyositis and SLE respectioely. The duodenal vasculitic lesions demonstrated clinically by gastroduodenoscopy were confirmed histologically. Endoscopy revealed multiple early lesions, separated by mildly edematous or red inflamed mucosa in the superior duodenum in all patients. These lesions developed into erosions, dome-shaped shallow ulcers and bled profusely. Histological assessment of the gut biopsies revealed non-specific inflammation or ulceration and intramucosal hemorrhage. Areas of necrosis and ulceration in endoscopic biopsies were highly suggestive of vasculitis whereas arteritis was seen in surgical specimens only.

 In conclusion, the duodenal vasculitic lesions presenting as an acute abdominal emergency are an uncommon, but often fatal presentation of systemic vasculitis. Endoscopic findings and early aggressive medical therapy may contribute significantly towards an overall successful outcome.


Copyright © 2002, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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