Intestinal Buerger's disease

We describe a 50-year-old man who, at 26 years of age, underwent a hemicolectomy on the right side of the abdomen due to infarction of the right colon. At 35 years of age, a stenotic, ischemic segment of distal jejunum was resected. Later he had had intermittent claudication, migratory thrombophlebitis, and recurrent cerebral infarctions. The mesenteric and mural blood vessels of both resected specimens of bowel showed an occlusive process with organized and recent thrombi and marked transmural inflammation. The internal elastic lamina and media in the arteries were preserved and there was no evidence of atheroma or calcification. The histologic findings were consistent with thromboangiitis obliterans. We suggest that the same mechanism may be responsible for intestinal peripheral and cerebrovascular involvement.