Chronic Antral Ulcer Associated With Gastroduodenal Lymphocytic Phlebitis
| Autor: | Craig A. Solem, Thomas C. Smyrk, Stephen C. Hauser, Susan C. Abraham |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Pathology Duodenum medicine.medical_treatment Thrombophlebitis Gastroenterology Pathology and Forensic Medicine Internal medicine Pyloric Antrum medicine Humans Lymphocytes Stomach Ulcer Aged Billroth II Gastrointestinal tract Vascular disease business.industry Stomach digestive oral and skin physiology medicine.disease Vagotomy Immunohistochemistry medicine.anatomical_structure Acute abdomen Chronic Disease Surgery Anatomy medicine.symptom Phlebitis business |
| Zdroj: | The American Journal of Surgical Pathology. 28:1659-1663 |
| ISSN: | 0147-5185 |
| DOI: | 10.1097/00000478-200412000-00018 |
| Popis: | Enterocolic lymphocytic phlebitis (ELP) is a rare cause of gastrointestinal ischemia. Unlike most vasculitic diseases affecting the gastrointestinal tract, ELP involves only the mural and mesenteric veins, which are surrounded by a lymphocytic and sometimes granulomatous infiltrate. The mesenteric arterial system and the systemic vasculature are characteristically spared. Most patients with ELP present with an acute abdomen that resolves following surgical resection of the involved bowel. ELP has been reported to involve the small bowel, colon, or both, but involvement of the upper gastrointestinal tract has not been previously described. Here we report a case of lymphocytic phlebitis that affected only the stomach and duodenum. The patient, a 68-year-old man, had a nonhealing gastric antral ulcer and underwent hemigastrectomy with vagotomy and Billroth II reconstruction. Both the resected stomach and duodenum showed characteristic lymphocytic and granulomatous infiltrates that involved the submucosal and mural veins, with associated obliteration of vascular lumina; the adjacent arteries were completely spared. The patient developed late postoperative complications including bile reflux gastritis and erosive esophagitis, but he had no recurrence of gastrointestinal ulceration or ischemia over a 2-year follow-up. We hypothesize that there may be more cases of upper gastrointestinal ELP than are diagnosed as such, in part because the diagnosis can be made only on surgical resections specimens. |
| Databáze: | OpenAIRE |
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