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digestive vasculitis

Tuesday 18 November 2003

Vasculitides can cause local or diffuse pathologic changes in the gastrointestinal tract, resulting in nonspecific paralytic ileus, mesenteric ischemia, submucosal edema and hemorrhage, or bowel perforation or stricture.

The extent and clinical course of disease depend on the size and location of the affected vessel and the histologic characteristics of the lesion.

Vasculitis may primarily involve large vessels (eg, giant cell arteritis, Takayasu arteritis), medium-sized vessels (eg, polyarteritis nodosa, Kawasaki disease, primary granulomatous central nervous system vasculitis), or small vessels (eg, Wegener granulomatosis, Churg-Strauss syndrome, microscopic polyangiitis, Henoch-Schönlein syndrome, systemic lupus erythematosus, rheumatoid vasculitis, Behçet syndrome).

Radiologic findings in various types of vasculitis often overlap considerably and therefore have limited value in making 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 tendency to concomitantly involve the small and large intestine, and are associated with genitourinary involvement.

Etiology

- systemic lupus erythematosus
- mixed connective tissue disease
- giant cell arteritis
- Takayasu disease
- Buerger disease
- leucocytoclastic vasculitis
- mixed cryoglubulinemia
- lupus vasculitis
- rheumatoid disease
- drug-induced vasculitis
- Behcet disease
- Kawasaki disease

See also

- digestive diseases
- digestive lesions
- digestive vascular anomalies

Open references

- Radiologic features of vasculitis involving the gastrointestinal tract. Ha HK, Lee SH, Rha SE, Kim JH, Byun JY, Lim HK, Chung JW, Kim JG, Kim PN, Lee MG, Auh YH. Radiographics. 2000 May-Jun;20(3):779-94. Review. PMID: 10835128 [Free]