Abstract
A 56-year-old man was admitted to the hospital because of abdominal distension, nausea, vomiting and diarrhea. During the three months before admission he lost 10 kg in weight.
Physical examination on admission showed markedly distended abdomen with a fluid wave, but no hepatic enlargement. Analysis of the ascitic fluid showed that it was transudate, with no evidence of malignancy or infection. An upper gastrointestinal with smallbowel study revealed marked dilatation of the jejunum. The final diagnosis was not made. He had persistent diarrhea and vomiting, and his condition gradually deteriorated.
An autopsy revealed marked fibrous contraction with stenosis of the small intestine at the region of about 170 cm distal from the fossa of Treitz.
Microscopically the most prominent feature was intense thrombophlebitis of the superior mesenteric vein and the portal vein.
On the basis of these results, the stenosis of the bowel was considerted to be due to infarction of the small intestinal veins resulting from thrombophlebitis.
