Open AccessRecurrent small bowel infarction in a young man: polycythaemia or vasculitis?
Author(s) -
Abdulzahra Hussain,
Taj Ansari,
Hind Mahmood,
J. P. M. Ellul
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.11.2008.1296
Subject(s) - medicine , polycythaemia , vomiting , physical examination , nausea , quadrant (abdomen) , surgery , infarction , vasculitis , gastroenterology , myocardial infarction , disease
A 29-year-old man presented with a 3 day history of right lower quadrant pain, nausea and vomiting. There was tenderness in the right lower quadrant. At surgery the appendix was normal but an infarcted terminal ileum segment was found and resected. Histopathological examination was suggestive of vasculitis. The patient was discharged in good condition and follow-up for the first year was unremarkable. Unfortunately he developed another episode of bowel ischaemia in the second year and underwent resection of a short segment of proximal ileum. An autoimmune profile was negative. However, subsequent blood tests confirmed polycythaemia. Small bowel infarction due to polycythaemia in a young patient is rare and may be difficult to diagnose on clinical grounds.