Case Report of Allergic Granulomatous Angitis Performed Enterectomy due to Mechanical Obstruction

Yoshiaki Shindo, Kazuo Tenma, Hiroshi Imano, Masanori Hibino, Kei Yoshino and Masaaki Nakamura

Department of Surgery, Ogachi Chuo Hospital

A 37-year-old man reporting abdominal pain and distension and diagnosed with ileus based on abdominal plain X-ray findings was admitted, but failed to respond to conservative therapy, necessitating surgery on hospital day 6. A 50 cm length of jejunum 15 cm anally from Treitz's ligament showed wall thickening and ischemic change suggesting impaired circulation and mesenteric lymphadenopathy. We partially resected the jejunum. Histopathological examination showed marked eosinophilic infiltration and fibrinoidal necrosis of the jejunal. The definitive diagnosis was allergic granulomatous angitis (AGA) based on allergic rhinitis, fever caused by angitis, weight loss, muscle pain, and main pathological findings. He has since suffered no AGA recurrence. We review the five cases reported in the Japanese literature of ileus caused by AGA and report this to broaden the knowledge available on this topic.

Key words
mechanical obstruction, allergic granulomatous angitis, enterectomy

Reprint requests
Yoshiaki Shindo Department of Surgery, Ogachi Chuo Hospital
25 Isamigaoka, Yamada, Yuzawa, 012-0055 JAPAN

Accepted
December 19, 2007

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