A case of thrombangiitis obliterans (TAO) in a man of 45 is reported. Buergen himself had already noted that TAO could include the mesenteric vessels as well. This gastrointestinal involvement has remained largely unknown: Since Buergers description only 3 cases with affection of the colon have been described. Since, is the patient described, the diagnosis was uncertain, a laparotomy was performed, during which a segment of transverse colon was resected along with a thickened piece of mesentery and the appendix. In the midportion of the removed colon, a 9-cm area of narrowing with ulcerated mucosa was seen. Microscopic examination showed large segments of mucosal ulceration with acute and chronic inflammatory changes. Within the areas of ulceration, numerous arterial branches were occluded by or organized and re-canalized thrombi. Similar arterial thrombotic occlusions were seen in areas free of mucosal ulceration, in a large artery of mesocolon, and in an artery of the mesoappendix. Several small venules likewise were occluded by recent thrombi. Arterial occlusions were characterized by highly recanalized thrombi, with just a few chronic inflammatory cells. Seven cases of histologically documented Buergers disease of the gastrointestinal tract have been previously reported; 3 of these involved the colon. The patient described is unusual because his symptoms suggested a primary gastrointestinal disorder. This case illustrates that the abdominal manifestations of Buerger's disease may be the first manifestation of this diffuse vascular disease.
ASJC Scopus subject areas