Abstract
A 68-year-old man visited our hospital with the chief complaints of abdominal pain and distension. Ileus was diagnosed based on the findings of abdominal plain X-ray, and the patient was then admitted. A long intestinal tube was inserted, but delirium occurred, and the patient cut the tube by himself. The whole tube remained in the small intestine, so a laparotomy was performed. The whole small intestine then showed a change of color that suggested impaired circulation. Mesenteric lymphadenopathy and gall bladder swelling were observed. We carried out removal of the long intestinal tube, a biopsy of the small intestine, and a cholecystectomy. Histopathological examination revealed remarkable eosinophilic infiltration in the small intestine, gall bladder and mesenteric lymph node. Vascular necrosis and surrounding eosinophilic infiltration were observed in part of the small intestine and gall bladder. This patient had suffered from bronchial asthma, and laboratory tests highlighted an increase in eosinophil count, IgE and rheumatoid factor. Thus, we diagnosed this patient as allergic granulomatous angiitis (AGA). Then he showed symptomatic improvement in response to the administration of steroid hormone postoperatively. At present this patient is followed with steroid hormone maintenance therapy.
