Intestinal Type of Thromboangiitis Obliterans (Buerger Disease) Preceding Symptoms of Severe Peripheral Arterial Disease

Arkkila, Perttu; Kahri, A.; Färkkilä, Martti

doi:10.1080/003655201750163259

Cited by 12 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More specifically, postprandial cramping and pain, as noted in our patient, has been identified in four other cases (7,11,12,15). The morphology of segmental bowel disease includes occasional stricture formation, with or without confounding acute necrosis (14)(15)(16)(17).…”

Section: Discussionsupporting

confidence: 63%

Intestinal Thromboangiitis Obliterans in a Woman: A Case Report and Discussion of Chronic Ischemic Changes

Medlicott

Beaudry

Morris

et al. 2003

Canadian Journal of Gastroenterology

View full text Add to dashboard Cite

Although traditionally regarded as a disease of distal extremities, mesenteric vasculature can also manifest thromboangiitis obliterans (TAO). There are 31 cases of intestinal TAO in the English literature and the majority of subjects are male. However, cases of women with TAO are becoming more common, coinciding with an increased incidence of smoking in this sex. We describe the sixth case of a female patient with classic extremity manifestations paralleled by paroxysms of abdominal angina. Intestinal TAO can mimic extremity disease of smoldering chronic ischemia punctuated by unpredictable acute episodes of gangrene. In the present case, chronic ischemia manifested as partial bowel obstruction due to stricture deformity of the ileum and profound adipocyte atrophy of mesentery.

show abstract

Section: Discussionsupporting

confidence: 63%

Intestinal Thromboangiitis Obliterans in a Woman: A Case Report and Discussion of Chronic Ischemic Changes

Medlicott

Beaudry

Morris

et al. 2003

Canadian Journal of Gastroenterology

View full text Add to dashboard Cite

show abstract

“…However, out of 50 cases of Buerger's disease involving the GI tract that has been reported, 12 cases have intestinal involvement as an inaugural presentation. (4) Cessation of smoking has high preventive value. Only 5% of ex-smokers progress to develop the disease in another site following abstinence from smoking in contrast to 100% progression rate in the patients who continue to smoke.…”

Section: Discussionmentioning

confidence: 99%

Intestinal thromboangiitis obliterans: Consequence of a delay in diagnosis

Mishra¹,

Mishra²,

Mitra³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Thromboangiitis obliterans (TAO) or Buerger’s disease is a form of peripheral vascular disease in young male smokers. The involvement of the intestine occurs only about 2% of the cases. Symptoms of peripheral vascular disease usually precede intestinal manifestations, although the latter can sometimes be the index presentation. The cessation of smoking usually, though not necessarily, prevents the progression of the disease and visceral involvement.Case presentation: Our patient presented with diffuse abdominal pain along with bouts of vomiting and loose motions. He was a known smoker with a prior history of amputation of the right foot, four years before. Physical examination revealed abdominal distension and diffuse tenderness and guarding. An omental band attached to the tip of the appendix was discovered at the initial exploration along with dilated proximal bowel loops, for which a release of the omental band along with appendectomy was done. He developed an enterocutaneous fistula on the sixth postoperative day for which the abdomen was re-explored which revealed multiple segmental perforation in the jejunum and two subcentimetric perforation adjacent to each other in the distal ileum. Resection of the affected jejunal segment was performed followed by Roux-en-Y gastrojejunosotomy and distal ileostomy. A feeding jejunostomy was also performed. The bleeding from the cut ends was unsatisfactory. The patient however had persistent feculent discharge from the wound for which a third exploration was done which revealed a leak from the gastrojejunostomy and feeding jejunosotomy sites, both of which were repaired primarily. However, the patient developed septicemia with persistently elevated serum lactate levels which progressed to refractory septic shock and ultimately succumbed to the illness on 23rd postoperative day of the index surgery.Conclusion: Acute abdomen in a young man, who is a chronic smoker and having an antecedent history of amputation of some part of an extremity for a nontraumatic cause should raise the suspicion of Buerger’s disease of the intestine. Although it is a progressive disease and things are already late by the time intestinal symptoms manifest, early detection may give some scope of salvage and decreasing morbidity and mortality.

show abstract

“…Gastrointestinal involvement of TAO remains rare, however, intestinal manifestations like stricture or perforation of the colon may become apparent long before symptoms of severe peripheral arterial disease in patients with TAO [ 14 ].…”

Section: Clinical Descriptionmentioning

confidence: 99%

Thromboangiitis obliterans (Buerger's disease)

Arkkila

2006

Orphanet J Rare Dis

101

View full text Add to dashboard Cite

Thromboangiitis obliterans or Buerger's disease is a segmental occlusive inflammatory condition of arteries and veins, characterized by thrombosis and recanalization of the affected vessels. It is a non-atherosclerotic inflammatory disease affecting small and medium sized arteries and veins of upper and lower extremities. The clinical criteria include: age under 45 years; current or recent history of tobacco use; presence of distal-extremity ischemia indicated by claudication, pain at rest, ischemic ulcers or gangrenes and documented by non-invasive vascular testing; exclusion of autoimmune diseases, hypercoagulable states and diabetes mellitus; exclusion of a proximal source of emboli by echocardiography or arteriography; consistent arteriographic findings in the clinically involved and non-involved limbs. The disease is found worldwide, the prevalence among all patients with peripheral arterial disease ranges from values as low as 0.5 to 5.6% in Western Europe to values as high as 45 to 63% in India, 16 to 66% in Korea and Japan, and 80% among Ashkenazi Jews. The etiology of thromboangiitis obliterans is unknown, but use or exposure to tobacco is central to the initiation and progression of the disease. If the patient smokes, stopping completely is an essential first step of treatment. The effectiveness of other treatments including vasodilating or anti-clotting drugs, surgical revascularization or sympathectomy in preventing amputation or treating pain, remains to be determined.

show abstract

Intestinal Type of Thromboangiitis Obliterans (Buerger Disease) Preceding Symptoms of Severe Peripheral Arterial Disease

Cited by 12 publications

References 10 publications

Intestinal Thromboangiitis Obliterans in a Woman: A Case Report and Discussion of Chronic Ischemic Changes

Intestinal Thromboangiitis Obliterans in a Woman: A Case Report and Discussion of Chronic Ischemic Changes

Intestinal thromboangiitis obliterans: Consequence of a delay in diagnosis

Thromboangiitis obliterans (Buerger's disease)

Contact Info

Product

Resources

About