Ischemic enteritis (IE) is a rare disorder which is caused by inadequate blood flow to small intestine. The diagnostic procedure of this disease has not sufficiently established because of its rarity. Here, we report a case of IE in a hemodialysis-dependent 70-year-old man and summarize the diagnostic options for IE. The patient was admitted to our hospital because of acute abdominal distention and vomiting. He presented with mild tenderness in the lower abdomen and slightly elevated C-reactive protein level as revealed by blood tests. Radiographic imaging showed small bowel obstruction due to a stricture in the distal ileum. Contrast-enhanced abdominal ultrasonography revealed a 7-cm stenotic site with increased intestinal wall thickening, which preserved mucosal blood perfusion. Elastography revealed a highly elastic alteration of the stenotic lesion, indicating benign fibrotic changes resulting from chronic insufficient blood flow. Based on a clinical diagnosis of IE with fibrous stenosis, a partial ileostomy was performed. After surgical treatment, oral intake was initiated without recurrence of intestinal obstruction. Pathological findings revealed deep ulceration with inflammatory cell infiltration at the stenotic site. Occlusion and hyalinization of the venules in the submucosal layer indicated IE. In addition to current case, we reviewed past case reports of IE. Through this case presentation and literature review, we summarize the usefulness and safety of transabdominal ultrasonography for diagnosing IE.
Case Rep Gastroenterol 2021;15:568–577

中文翻译：

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经腹超声诊断缺血性肠炎后纤维化回肠远端狭窄

缺血性肠炎 (IE) 是一种罕见的疾病，由流向小肠的血流量不足引起。由于其罕见，该疾病的诊断程序尚未充分建立。在这里，我们报告了一名依赖血液透析的 70 岁男性的 IE 病例，并总结了 IE 的诊断选择。患者因急性腹胀、呕吐入院。他的下腹部有轻微压痛，血液检查显示 C 反应蛋白水平略有升高。放射影像显示由于回肠远端狭窄导致小肠梗阻。腹部超声造影显示有一个 7 厘米的狭窄部位，肠壁增厚增加，保留了粘膜血液灌注。弹性成像显示狭窄病变的高弹性改变，表明由慢性血流量不足引起的良性纤维化变化。基于 IE 伴纤维性狭窄的临床诊断，进行了部分回肠造口术。手术治疗后开始口服，肠梗阻未复发。病理结果显示狭窄部位深部溃疡伴炎症细胞浸润。黏膜下层小静脉的闭塞和透明化表明 IE。除了当前的案例，我们还回顾了过去的 IE 案例报告。通过本病例介绍和文献回顾，我们总结了经腹超声检查诊断 IE 的有用性和安全性。基于 IE 伴纤维性狭窄的临床诊断，进行了部分回肠造口术。手术治疗后开始口服，肠梗阻未复发。病理结果显示狭窄部位深部溃疡伴炎症细胞浸润。黏膜下层小静脉的闭塞和透明化表明 IE。除了当前的案例，我们还回顾了过去的 IE 案例报告。通过本病例介绍和文献回顾，我们总结了经腹超声检查诊断 IE 的有用性和安全性。基于 IE 伴纤维性狭窄的临床诊断，进行了部分回肠造口术。手术治疗后开始口服，肠梗阻未复发。病理结果显示狭窄部位深部溃疡伴炎症细胞浸润。黏膜下层小静脉的闭塞和透明化表明 IE。除了当前的案例，我们还回顾了过去的 IE 案例报告。通过本病例介绍和文献回顾，我们总结了经腹超声检查诊断 IE 的有用性和安全性。病理结果显示狭窄部位深部溃疡伴炎症细胞浸润。黏膜下层小静脉的闭塞和透明化表明 IE。除了当前的案例，我们还回顾了过去的 IE 案例报告。通过本病例介绍和文献回顾，我们总结了经腹超声检查诊断 IE 的有用性和安全性。病理结果显示狭窄部位深部溃疡伴炎症细胞浸润。黏膜下层小静脉的闭塞和透明化表明 IE。除了当前的案例，我们还回顾了过去的 IE 案例报告。通过本病例介绍和文献回顾，我们总结了经腹超声检查诊断 IE 的有用性和安全性。
Case Rep Gastroenterol 2021；15:568–577