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Clinical Features and Radiographic Findings in Ischemic Enteritis (Jejunoileitis) Mitsuo Iida 1 1The Second Department of Internal Medicine, Faculty of Medicine, Kyushu University Keyword: 虚血性小腸炎 , 炎症性腸疾患 , 虚血性小腸狭窄 , 母指圧痕像 , 管状狭窄 pp.523-535
Published Date 1990/5/25
DOI https://doi.org/10.11477/mf.1403110877
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 Fifteen cases of ischemic enteritis (jejunoileitis), 11 with the stricturing form and 4 with the tansient form, were studied to find the characteristic clinical features and radiographic findings. The average age of the patients was 59 years, the range being 40 to 88 years. The ratio of males to females was 11 : 4. The initial symptoms included abdominal pain, melena, and diarrhea. The onset of the illness was sudden in 12 cases and subacute in 3. The lesion was most frequently sited in the ileum. The intial area of involvement was 3 to 38 cm in length in all but 3 patients who had a more extensive lesion. The most characteristic radiographic findings were thumb-printing and edematous folds in the acute stage of this disease. In patients with the stricturing form, tubular narrowing, dilated proximal bowel, and multiple small ulcers were observed in the healing stage. Pathological finding of the resected specimen revealed zonal ulcer and annular stricture with relatively shallow ulcers. The irregular contour of tubular narrowing on the radiograph was consistent with granular appearance (histologically, consisting of mucosal hyperplasia, granulation tissue or regenerative mucosa) and/or multiple fissures. Eccentric deformity and sacculation were demonstrated in only one case. We consider that radiographic differentiation of this disease from other inflammatory bowel diseases such as intestinal anisakiasis, Crohn's disease, and intestinal tuberculosis is important.


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