Abstract
IntroductionSmall intestinal strictures secondary to mesenteric vessel thrombosis are a rare entity and thus often result in delayed diagnosis. We present two cases of ischaemic small bowel strictures secondary to mesenteric vessel thrombosis, and describe how they were subsequently managed.Case presentationWe present two cases of abdominal pain, one acute and one chronic, in which the eventual diagnosis was of bowel strictures secondary to arterial and venous vessel thrombosis. In both patients, a Caucasian male aged 67 and a Caucasian female aged 78, the diagnosis was delayed because of the infrequency of their presentation. Both patients eventually underwent a resection of the affected portion of bowel with primary anastamosis and made uneventful recoveries.ConclusionThere are multiple medical and surgical management options for small bowel strictures and these depend on the aetiology of the stricture. Ischaemic small bowel strictures represent a difficult diagnosis and the potential resulting delay may be partially responsible for increased morbidity. Barium small bowel follow-through should be used in making the diagnosis.
Highlights
Small intestinal strictures secondary to mesenteric vessel thrombosis are a rare entity and often result in delayed diagnosis
We present two cases of ischaemic small bowel strictures secondary to mesenteric vessel thrombosis, and describe how they were subsequently managed
Case presentation: We present two cases of abdominal pain, one acute and one chronic, in which the eventual diagnosis was of bowel strictures secondary to arterial and venous vessel thrombosis
Summary
Small intestinal strictures secondary to mesenteric vessel thrombosis are a rare entity and often result in delayed diagnosis. The patient often presents with chronic bouts of abdominal pain associated with symptoms of intermittent small bowel obstruction. Patient 1 A 67-year-old Caucasian man presented acutely with a 5-day history of recurrent bouts of epigastric pain, nausea and vomiting. His previous surgical history included coronary artery bypass surgery, appendicectomy and open cholecystectomy with subsequent surgery for recurrent incisional hernia. Patient 2 A 78-year-old Caucasian woman presented with sudden onset abdominal pain with associated nausea and vomiting. She had a past medical history of a myocardial infarction, chronic obstructive pulmonary disease (COPD), transitional cell carcinoma of the bladder and an appendicectomy as a child. The patient made an uneventful recovery and was discharged 5 days later
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