BMJ Case Reports 2009; doi:10.1136/bcr.11.2008.1296
  • Rare disease

Recurrent small bowel infarction in a young man: polycythaemia or vasculitis?

  1. Abdulzahra Hussain1,
  2. Taj Ansari2,
  3. Hind Mahmood2,
  4. Joe Ellul2
  1. 1
    Princess Royal University Hospital, Farnborough Common, Orpington, BR6 8ND, UK
  2. 2
    Princess Royal University Hospital, General Surgery, Farnborough Common, Orpington, BR6 8ND, UK
  1. Abdulzahra Hussain, azahrahussain{at}
  • Published 6 August 2009


A 29-year-old man presented with a 3 day history of right lower quadrant pain, nausea and vomiting. There was tenderness in the right lower quadrant. At surgery the appendix was normal but an infarcted terminal ileum segment was found and resected. Histopathological examination was suggestive of vasculitis. The patient was discharged in good condition and follow-up for the first year was unremarkable. Unfortunately he developed another episode of bowel ischaemia in the second year and underwent resection of a short segment of proximal ileum. An autoimmune profile was negative. However, subsequent blood tests confirmed polycythaemia. Small bowel infarction due to polycythaemia in a young patient is rare and may be difficult to diagnose on clinical grounds.


  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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