M. Ito et al., INTESTINAL ISCHEMIA RESULTING FROM BUERGERS-DISEASE - REPORT OF A CASE, SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY, 23(11), 1993, pp. 988-992
A 42-year-old man who had undergone below-the-knee amputations for Bue
rger's disease 9 and 14 years earlier required emergency surgery for i
ntestinal ischemia caused by arterial occlusive lesions in the mesente
ry. The cecum and proximal part of the ascending colon were resected,
and marked hyperemic thickening of the wall and severe fibrous adhesio
ns were found. Postoperative angiography revealed occlusions in the su
perior mesenteric and right external iliac arteries. The resected spec
imen showed mucosal necrosis of the cecum and circular ulcers at Bauhi
n's valve and at the ascending colon. Microscopically, small mesenteri
c vessels were occluded by organized and recanalized thrombi with pres
erved vascular architecture. The patient has remained free of any furt
her intestinal symptoms for 1 year following his discharge from hospit
al.