Atypical Clinical Presentation of Crohn's Disease with Superior Mesenteric Vein Obstruction and Protein-losing Enteropathy

Intern Med. 2019 Feb 1;58(3):369-374. doi: 10.2169/internalmedicine.1192-18. Epub 2018 Sep 12.

Abstract

We herein report a 44-year-old man suffering from systemic edema due to protein-losing enteropathy (PLE) with superior mesenteric vein (SMV) obstruction and development of collateral veins, which subsequently proved to be a chronic result of thrombosis and a complication of Crohn's disease (CD). PLE was supposedly induced by both intestinal erosion and thrombosis-related lymphangiectasia, which was histologically proven in his surgically-resected ileal stenosis. Elemental diet and anti-TNFα agent improved his hypoalbuminemia after surgery. The rarity of the simultaneous coexistence of SMV obstruction and PLE and the precedence of these complications over typical abdominal symptoms of CD made the clinical course complex.

Keywords: Crohn's disease (CD); mesenteric vein thrombosis; protein-losing enteropathy (PLE).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Crohn Disease / complications*
  • Crohn Disease / physiopathology*
  • Crohn Disease / therapy
  • Humans
  • Male
  • Mesenteric Veins / physiopathology*
  • Protein-Losing Enteropathies / etiology*
  • Protein-Losing Enteropathies / physiopathology*
  • Protein-Losing Enteropathies / therapy
  • Treatment Outcome
  • Venous Thrombosis / complications
  • Venous Thrombosis / etiology
  • Venous Thrombosis / physiopathology*
  • Venous Thrombosis / therapy