Chronic myeloid leukaemia presenting as acute small bowel gangrene

Abstract

Rationale: Chronic myeloid leukaemia is a myeloproliferative disorder due to clonal hyperproliferation of myeloid cells within the bone marrow. It can present both pro- and anti-thrombotic states. CML has different presentations within the gastrointestinal tract. Patient's concern: A 40-year-old non-diabetic and non-hypertensive male complained of abdominal pain with nausea and emesis for 1 day. Besides, he had a history of abdominal distension and fever for 1 day. Diagnosis: Acute small bowel gangrene due to chronic myeloid leukaemia. Intervention: A limited resection of small intestine with ileostomy and mucus fistula. Outcome: After 3 months following surgery the patient underwent stoma closure. The patient was followed up for more than 3 years postoperatively. During the follow-up, the patient was asymptomatic without any recurrence of the disease. Lesson: Chronic myeloid leukaemia should be considered as one of the causes for small intestine gangrene when there is increased leukocyte count, splenomegaly without evidence of atherosclerotic occlusion or systemic emboli from the heart.