Case Report
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World J Gastroenterol. May 14, 2013; 19(18): 2830-2834
Published online May 14, 2013. doi: 10.3748/wjg.v19.i18.2830
Polyarteritis nodosa diagnosed by surgically resected jejunal necrosis following acute abdomen
Yuta Hiraike, Makoto Kodaira, Munetaka Sano, Yasuyuki Terazawa, Shingo Yamagata, Syuzo Terada, Masaharu Ohura, Ken Kuriki
Yuta Hiraike, Makoto Kodaira, Munetaka Sano, Yasuyuki Terazawa, Shingo Yamagata, Syuzo Terada, Department of Gastroenterology, Yaizu City Hospital, Yaizu City, Shizuoka 425-8505, Japan
Masaharu Ohura, Department of Nephrology, Yaizu City Hospital, Yaizu City, Shizuoka 425-8505, Japan
Ken Kuriki, Department of Pathology, Yaizu City Hospital, Yaizu City, Shizuoka 425-8505, Japan
Author contributions: Hiraike Y mainly contributed to this work; Kodaira M and Ohura M supervised the work; Kuriki K performed pathological analysis; Sano M, Terazawa Y, Yamagata S and Terada S contributed to discussion and review of the manuscript.
Correspondence to: Yuta Hiraike, MD, Department of Gastroenterology, Yaizu City Hospital, Doubara 1000, Yaizu City, Shizuoka 425-8505, Japan. hiraike-tky@umin.net
Telephone: +81-54-6233111 Fax: +81-54-6239103
Received: January 18, 2013
Revised: March 2, 2013
Accepted: March 23, 2013
Published online: May 14, 2013
Core Tip

Core tip: Our case shows the importance of vasculitis, including polyarteritis nodosa, as a differential diagnosis in case of acute abdomen. Here we provide comprehensive review of gastrointestinal organ involvement in Polyarteritis nodosa, and concluded that gastrointestinal lesions, especially small intestinal lesion, is relatively common manifestation and that suggests high mortality. Then we draw two findings, bowel wall thickening limited to jejunum and unexplained renal dysfunction, as possible clues that might led us to earlier diagnosis in this case. Additionally, we discuss possible relationship between pathophysiology of intestinal ischemia and radiological findings.