Clinicopathologic Study on Ischemic Stricture of the Small Intestine Akinori Iwashita 1 1Department of Pathology, Fukuoka University Chikushi Hospital Keyword: 虚血性小腸狭窄 , 虚血性小腸炎 , 狭窄型虚血性小腸炎 , 小腸虚血 pp.557-569
Published Date 1990/5/25
DOI https://doi.org/10.11477/mf.1403110881
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 Clinicopathologic study on ischemic stricture of the small intestine was carried out in 18 resected specimens obtained from 18 patients. The results obtained were as follows.

 1) Of the 18 patients, five had histories of abdominal trauma and the remainder had histories neither of abdominal trauma, nor strangulated hernia, nor radiotherapy or treatment for arterial hypertenstion. Pathomorphologic findings in both groups were almost identical.

 2) The macroscopic characteristics of the lesions were tubular and concentric stenosis, annular and segmental ulcer, and marked thickening of the wall in the narrowed segments.

 3) The microscopic appearances were composed of five main pictures as follows; 1) ulcers of Ul-Ⅱ to Ul-Ⅳ, 2) open ulcers floored with richly vascular granulation tissue, 3) prominent fibromusculosis and fibrosis mainly in the submucosa, 4) relatively marked inflammatory infiltrate consisting chiefly of lymphocytes and plasma cells, 5) presence of hemosiderin-laden macrophages scattered through the entire thickness of the intestine.

 4) Among pathomorphologic findings, regarded as the causative factors, were slight to moderate fibromuscular intimal thickening of the small to medium-sized arteries situaed in the serosa (15 cases), organized and recanalized thrombus (4 cases), and marked thickening of the lymphatic wall (4 cases).

 According to the results obtained, brief discussion was made on its pathomorphologic characteristics, causative factors and differential diagnosis, and on the pathomorphologic differences between ischemic stricture of the small intestine and ischemic colitis of the stricture type.

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