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A middle-aged patient with chronic obstructive pulmonary disease (COPD) gold III was admitted to the intensive care unit with an acute, severe exacerbation of COPD. Six days after admission, the patient developed acute kidney injury with hyperkalaemia, for which the patient was treated. Kidney function further deteriorated and after 3 days, continuous venovenous haemofiltration was started. Several days later, a paralytic ileus developed. Subsequently, the patient underwent an exploratory laparotomy, which revealed fibrinous deposits and oedematous, poorly perfused and ischaemic small intestines with two perforations. The resection specimen was submitted for histopathological examination.
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Ischaemic enteritis due to vasculitis.
Handling editor Iskander Chaudhry.
Contributors Conception and design of study: JMAB, JGvdH, BMvdK, LAB. Acquisition of patient data and literature: JMAB, EEAA, LAB. Analysis and/or interpretation of data and literature: JMAB, EEAA, LAB. Drafting the manuscript: JMAB, LAB. Revising the manuscript critically for important intellectual content: JMAB, JGvdH, EEAA, BMvdK, LAB. Approval of the version of the manuscript to be published: JMAB, JGvdH, EEAA, BMvdK, LAB. All authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing or revision of the manuscript.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; internally peer reviewed.