[Buerger's disease disclosed by a perforation in the digestive system. Apropos of a case and review of the literature]. / Maladie de Buerger révélée par une perforation digestive. A propos d'un cas et revue de la littérature.

A 27 year-old man who underwent an intestinal segmental resection for small bowel perforation was hospitalized for chronic abdominal pain with weight loss. Coeliac and mesenteric stenosis was diagnosed and laparotomy was performed. Histologic findings were consistent with Buerger's disease. One month later, he developed intermittent claudication of the left leg, and 8 years later amputation of a toe was performed. Since 1956, 25 cases of abdominal Buerger's disease has been reported in the literature. In eight cases, intestinal involvement inaugurated the disease. The clinical presentation can be various: chronic abdominal pain, mesenteric infartus, occlusion, perforation. Small bowel, colon and rectum can be concerned. The literature points out a mortality rate of 25% in intestinal Buerger's disease, contrasting with a mortality rate of 4% in peripheral forms of the disease. Although rare, intestinal form of Buerger's disease should be diagnosed early, because of its high mortality rate. Doppler of mesenteric arteries may contribute to the early diagnosis.