Anorexia nervosa with ischemic necrosis of the segmental ileum and cecum

A 41-year-old woman with long-standing anorexia nervosa showed paralytic il eus and serum creatine kinase elevation, Surgical treatment showed necrosis of the segmental ileum and cecum with perforation. She died of septic shoc k 3 days after the operation. Postmortem examination revealed no occlusion of the superior mesenteric artery or its main branches, and no arterioscler otic changes. Histological examinations confirmed non-occlusive mesenteric infarction. This case suggested that necrosis of bowels might have been cau sed by poor blood supply due to severe malnutrition and dehydration for man y years, which could be one of the fatal complications of anorexia nervosa.