Mesenteric vasculitis A diagnostic dilemma

Mesenteric vasculitis is a rare diagnosis. Although it has been described more than a century ago, clinicians still face difficulties in making an early diagnosis. We report a case who presented with symptoms of severe rheumatoid arthritis [RA] and abdominal pain and subsequently twice developed intestinal perforation within a period of one week. Laparotomy on both occasions disclosed multiple subserosal small bowel ulcers, histopathology of which was reported as polyarteritis nodosa. While early surgical intervention might be life saving in a localised small bowel vasculitis, its efficacy in progressive involvement of multiple segments is doubtful