Abstract
We report a case of polyarteritis nodosa with stenosis of the sigmoid colon. A 60-year-old man was admitted to the hospital complaining of abdominal pain and high fever. Although he received medical treatment, his symptoms did not improve. Barium enema and colonoscopy revealed severe stenosis and mucosal redness of the sigmoid colon. Abdominal CT scan showed splenic artery aneurysms and small hepatic artery aneurysms. Celiac and right renal arteriography showed small multiple aneurysms. Moreover, inferior mesenteric arteriography showed occlusion of the sigmoidal arteries and aneurysms of branches of the left colic and the superior rectal artery. From the results, stenosis of the sigmoid colon was diagnosed preoperatively and an operation was performed. During the operation, contraction of the sigmoid colon, thickening of the mesocolon and adhesion of the ileum to the sigmoid colon were found. Although ischemic change of the serosa of the colorectum was not recognized, the left colon measuring 23cm in length was resected while assessing the circulation with a laser flowmeter. His postoperative course was uneventful. We diagnosed polyarteritis nodosa from the findings of the pathologic specimens. Although the gastrointestinal tract is frequently involved in polyarteritis nodosa, it is relatively rare to involve the colorectum. We retrospectively reviewed 22 cases with polyarteritis nodosa involving the colorectum in the Japanese literature.
