Enteritis necroticans 'pigbel' is caused by Clostridium perfringens type C but has rarely been reported in developed countries. A 50-year-old Japanese man with untreated diabetes mellitus (DM) presented with diarrhea and abdominal pain. Intraoperative endoscopic and macroscopic examination disclosed segmental annular mucosal lesions characteristic of clostridial enteritis. Clostridial infection type C was verified on pathological, and immunohistochemical analysis. Although rare, the disease is likely to be underdiagnosed. Hence, the pathology and immunohistochemistry of segmental enteritis with annular mucosal lesions should be examined to establish a diagnosis of enteritis necroticans even in mildly affected patients, and especially those with DM.

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A 56-year-old man presenting with abdominal pain had an elevated serum immunoglobulin 4 (IgG4) concentration. Computed tomography angiography revealed a celiacomesenteric trunk aneurysm with wall. After admission, the celiacomesenteric trunk aneurysm grew rapidly along with wall thinning. Emergency transcatheter arterial embolization was completed using detachable coils. After transcatheter arterial embolization, the patient's abdominal pain disappeared completely. Steroid administration, which continues to the present day, was started 1 month after the transcatheter arterial embolization. No clinical symptoms associated with recurrent arteritis or other IgG4-related disease have been confirmed.