Radiologic features of vasculitis involving the gastrointestinal tract

Vasculitides can cause local or diffuse pathologic changes in the gastroint estinal tract, resulting in nonspecific paralytic ileus, mesenteric ischemi a, submucosal edema and hemorrhage, or bowel perforation or stricture. The extent and clinical course of disease depend on the size and location of th e affected vessel and the histologic characteristics of the lesion. Vasculi tis may primarily involve large vessels (eg, giant cell arteritis, Takayasu arteritis), medium-sized vessels (eg, polyarteritis nodosa., Kawasaki dise ase, primary granulomatous central nervous system vasculitis), or small ves sels (eg, Wegener granulomatosis, Churg-Strauss syndrome, microscopic polya ngiitis, Henoch-Schonlein syndrome, systemic lupus erythematosus, rheumatoi d vasculitis, Behcet syndrome). Radiologic findings in various types of vas culitis often overlap considerably and therefore have limited value in maki ng a specific diagnosis. Nevertheless, the possibility of vasculitis should be considered whenever mesenteric ischemic changes occur in young patients , are noted at unusual sites (eg, stomach, duodenum, rectum), have a tenden cy to concomitantly involve the small and large intestine, and are associat ed with genitourinary involvement. Knowledge of systemic clinical manifesta tions in affected patients may suggest and even help establish the specific diagnosis.