Hokama A, Kishimoto K, Ihama Y, Kobashigawa C, Nakamoto M, Hirata T, Kinjo N, Higa F, Tateyama M, Kinjo F, Iseki K, Kato S, Fujita J. Endoscopic and radiographic features of gastrointestinal involvement in vasculitis. World J Gastrointest Endosc 2012; 4(3): 50-56 [PMID: 22442741 DOI: 10.4253/wjge.v4.i3.50]
Corresponding Author of This Article
Akira Hokama, MD, PhD, Assistant Professor, Department of Infectious, Respiratory and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0125, Japan. hokama-a@med.u-ryukyu.ac.jp
Article-Type of This Article
Editorial
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Akira Hokama, Kazuto Kishimoto, Yasushi Ihama, Tetsuo Hirata, Futoshi Higa, Masao Tateyama, Jiro Fujita, Department of Infectious, Respiratory and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0125, Japan
Chiharu Kobashigawa, Manabu Nakamoto, Nagisa Kinjo, Fukunori Kinjo, Endoscopy Unit, University Hospital of the Ryukyus, Okinawa 903-0125, Japan
Kunitoshi Iseki, Dialysis Unit, University Hospital of the Ryukyus, Okinawa 903-0125, Japan
Seiya Kato, Department of Pathology and Cell Biology, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0125, Japan
Author contributions: Hokama A wrote the manuscript; Hokama A, Kishimoto K, Ihama Y, Kobashigawa C, Nakamoto M, Hirata T and Kinjo N performed endoscopic examinations and treated the patients; Hokama A and Kato S performed the pathological examinations; Higa F, Tateyama M, Kinjo F, Iseki K and Fujita J supervised treatment of the patients and preparation of the manuscript.
Correspondence to: Akira Hokama, MD, PhD, Assistant Professor, Department of Infectious, Respiratory and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0125, Japan. hokama-a@med.u-ryukyu.ac.jp
Telephone: +81-98-8951144 Fax: +81-98-8951414
Received: May 20, 2011 Revised: November 4, 2011 Accepted: March 1, 2012 Published online: March 16, 2012
Abstract
Vasculitis is an inflammation of vessel walls, followed by alteration of the blood flow and damage to the dependent organ. Vasculitis can cause local or diffuse pathologic changes in the gastrointestinal (GI) tract. The variety of GI lesions includes ulcer, submucosal edema, hemorrhage, paralytic ileus, mesenteric ischemia, bowel obstruction, and life-threatening perforation.The endoscopic and radiographic features of GI involvement in vasculitisare reviewed with the emphasis on small-vessel vasculitis by presenting our typical cases, including Churg-Strauss syndrome, Henoch-Schönlein purpura, systemic lupus erythematosus, and Behçet’s disease. Important endoscopic features are ischemic enterocolitis and ulcer. Characteristic computed tomographic findings include bowel wall thickening with the target sign and engorgement of mesenteric vessels with comb sign. Knowledge of endoscopic and radiographic GI manifestations can help make an early diagnosis and establish treatment strategy.
