Journal Article

Angiographic and Immunologic Studies in Acute Necrotizing Jejunoileitis

V. V. S. S. Chandrasekharam, D. N. Srivastava, M. Mathur and V. Bhatnagar

in Journal of Tropical Pediatrics

Volume 48, issue 2, pages 88-92
Published in print April 2002 | ISSN: 0142-6338
Published online April 2002 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/48.2.88
Angiographic and Immunologic Studies in Acute Necrotizing Jejunoileitis

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Eighteen cases of laparotomy‐proven acute necrotizing jejunoileitis were treated during the period 1992–1998. Routine laboratory investigations and bacteriological studies were non‐contributory towards establishing an etiological basis for the diagnosis. Superior mesenteric artery digital subtraction angiography, carried out in five patients, demonstrated extensive neovascularization. IgG, IgM and IgA were normal in all eight children in whom it was measured; IgE levels were grossly elevated (mean 900 IU/ml; normal range 0–100 IU/ml). Four cases had evidence of hypersensitivity reactions (type I in one patient and type III in three patients) on histopathological examination of the resected small bowel. In addition, histopathological examination also showed the neovascularization observed on angiography. The evidence suggests an immunologically mediated insult resulting in intense vasculitis, which in turn causes ischemic damage to the bowel wall.

Journal Article.  0 words. 

Subjects: Paediatrics

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