PMC5602821_01
Enhanced abdominal computed tomography in axial and coronal plans showing: (A) circumferential wall thickness of ileum with a target appearance due to submucosal edema and an ileal perforation (white arrow) upstream of a wall stenosis (black arrow); (B, C) dilated ileocolic vein (white arrow) with accumulation of ectasic veins within the submucosa of right and left ileal loops (black arrows).
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Several infarcted small bowel loops with pneumatosis and extraluminal gas bubbles indicating perforation were also found (Fig. 1A). Further findings at computed tomography examination included vascular abnormalities consisting of a dilated and tortuous ileocolic vein with an accumulation of ectasic vessels within the submucosa of the distal ileum (Fig. 1B and C).
Ileal resected specimen showing alternating zones of stenosis and mild dilatation. The vascular abnormalities cannot be seen because of their submucosal localization.
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The results showed a diffuse ileal wall thickness with segmental and multifocal ileal wall stenosis zones alternating with dilated zones (Fig. 2).
Microscopic analysis of ileal resected specimen showing ishemic lesions of ileal mucosa (A) (HE, original magnification x25) and cluster of dilated veins and veinules in ileal submucosa (B) (HE, original magnification x25).
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Ischemic changes of ileum were found (Fig. 3A). Further findings on histologic examination included vascular lesions characterized by the presence of dilated and tortuous vascular veins and veinules in the submucosa of the ileum (Fig. 3B).