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Small bowel infarction in a patient with coeliac disease
  1. A McNeill1,
  2. F Duthie2,
  3. D J Galloway3
  1. 1Freeman Hospital, High Heaton, Newcastle upon Tyne, NE7 7DN, UK
  2. 2Department of Pathology, Western Infirmary, Dumbarton Road, Glasgow G11 6NT, UK
  3. 3Department of Surgical Gastroenterology, Gartnavel General Hospital, Great Western Road. Glasgow G12 0YN, UK
  1. Correspondence to:
 Dr A McNeill
 11 Broomieknowe Park, Bonnyrigg, Midlothian, EH19 2JB, UK; AMcNeill{at}doctors.org.uk

Abstract

A 40 year old man was admitted with a four week history of intractable diarrhoea and abdominal pain. A clinical diagnosis of inflammatory bowel disease was supported by biopsies of colonic mucosa. There was no response to Mesalazine and over 12 days the patient became critically ill with diarrhoea, hypovolaemia, and peritonism. A laparotomy was performed and 130 cm of infarcted ileum was resected. Extensive investigations excluded thrombophilia and echocardiography excluded intracardiac thrombus. Postoperatively the patient continued to have diarrhoea and he was diagnosed with coeliac disease on the basis of positive antiendomysial and antitissue transglutaminase autoantibodies and duodenal histology. Although there is no proof that mesenteric infarction occurred as a direct consequence of coeliac disease, clinicians should be aware of this possibility.

  • CD, coeliac disease
  • IBD, inflammatory bowel disease
  • IEL, intraepithelial lymphocyte
  • LC, lymphocytic colitis
  • coeliac disease
  • histopathology
  • mesenteric infarction
  • tissue transglutaminase

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