Case report of suspected Takayasu arteritis manifesting as chronic mesenteric ischaemia: a rare cause for a typical clinical picture

Authors

  • Antonio Duarte Division of Vascular Surgery, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal https://orcid.org/0000-0002-3867-6730
  • Alice Lopes Division of Vascular Surgery, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
  • Gonçalo Sobrinho Division of Vascular Surgery, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; School of Medicine, University of Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal
  • Luís Mendes Pedro Division of Vascular Surgery, Heart and Vessels Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; School of Medicine, University of Lisbon, Portugal; Lisbon Academic Medical Centre, Lisbon, Portugal

DOI:

https://doi.org/10.48750/acv.432

Keywords:

isquemia intestinal, vasculitis, Takayasu arteritis, mesenteric ischemia

Abstract

INTRODUCTION: Chronic intestinal ischemia accounts for approximately 1:1,000,000 admissions in some epidemiological studies. This condition usually affects individuals with known atherosclerotic lesion in other territories. Although typically found in female patients in their seventh decade of life with established arterial disease, chronic intestinal ischemia may manifest itself in younger patients. In the latter case, unusual causes, such as vasculitis, must be included in the differential diagnosis.

CASE REPORT: We report the case of a 31-year-old man with a known history of intermittent left and right upper limb claudication and smoking. He complained of postprandial epigastric pain in the previous year, with unvoluntary weight loss (6kg in the previous 6 months) and fear of eating. An angio CT scan was performed, which showed occlusion of the celiac trunk and superior mesenteric artery at its origin. The diagnosis of chronic intestinal ischemia was formulated, and the patient was submitted to an antegrade bypass from the supraceliac aorta to the superior mesenteric artery and common hepatic artery, with a bifurcated Dacron graft.

DISCUSSION: Given the inflammatory nature of the collected fragment of aorta, the onset of intestinal ischemia at a young age and the remaining peripheral arterial manifestations, a presumptive diagnosis of Takayasu’s arteritis was formulated. This vasculitis is typically found in patients in their third decade and is associated with diffuse arterial thickening. Mesenteric manifestations in this condition can occur up to 30%.

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References

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Published

2022-07-01

How to Cite

1.
Duarte A, Lopes A, Sobrinho G, Mendes Pedro L. Case report of suspected Takayasu arteritis manifesting as chronic mesenteric ischaemia: a rare cause for a typical clinical picture. Angiol Cir Vasc [Internet]. 2022 Jul. 1 [cited 2022 Aug. 18];18(1):40-6. Available from: https://acvjournal.com/index.php/acv/article/view/432

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Clinical Case