Mesenteric Buerger's Disease

ABSTRACT

Thromboangiitis obliterans (Buerger's disease) is an uncommon vaso-occlusive, inflammatory disease, occurring in young smokers. It predominantly produces occlusion of small to medium-sized arteries and veins, especially the distal arteries and veins of the upper and lower extremities. Buerger, in his original description, noted that vascular obliteration could involve the mesenteric vessels, but no true series have been reported. Instead, publications have focused on case reports and most reported cases had significant peripheral vascular manifestations of Buerger's disease before developing mesenteric involvement. Considering the difficulty in early diagnosis and poor prognosis, young smokers with established or suspicious clinical manifestations of extremity Buerger's disease presenting with gastrointestinal manifestations should be carefully evaluated with a high index of suspicion. If mesenteric Buerger's disease is suspected clinically or angiographically, early surgical intervention including diagnostic laparoscopy is recommended to prevent or limit bowel gangrene. We report two cases of Buerger's disease with mesenteric involvement.