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Revista médica de Chile

Print version ISSN 0034-9887

Abstract

CORNEJO R, Rodrigo; GATICA R, Héctor; SEGOVIA R, Erico  and  CORTES M, Claudia. Intestinal necrosis as clinical presentation of Takayasu's arteritis. Rev. méd. Chile [online]. 2002, vol.130, n.10, pp.1159-1164. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872002001000011.

A 32 years old female was admitted to hospital due to acute abdominal pain, nausea, vomiting and liquid stools. Physical examination was normal except for pain on her left inferior abdominal quadrant without peritoneal irritation signs. An abdominal CAT-scan suggested thrombosis at celiac trunk, although the echo Doppler showed no alterations except for signs of ischemia in the distal branch of the superior mesenteric artery. An exploratory laparotomy was performed disclosing a necrosis of the distal ileum and cecum, diffuse peritonitis and thrombosis of the ileocecoapendiculocolic artery. No vasculitis lesions were found in the arteries of medium size examined. A history of intermittent claudication for the past 3 years as well as acrocyanosis, asymmetry of pulses and blood pressure in the superior extremities was ascertained after the surgery. A MRI angiogram showed multiple stenoses and irregularities at the celiac trunk, hepatic, superior mesenteric and fibular arteries. No abnormalities at the aortic arch and its main branches were documented. A sepsis due to Candida sp complicated her postoperatory period. After recovery, prednisone 1 mg/kg/day was started and the anticoagulation continued. The abdominal pain, intermittent claudication and superior limb acrocyanosis disappeared. This is an unusual case of type IV Takayasu's arteritis with acute abdominal signs as the first manifestation (Rev Méd Chile 2002; 130: 1159-64)

Keywords : Magnetic resonance imaging; Mesenteric vascular occlusion; Takayasu's arteritis.

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