Wang W, Korah M, Bessoff KE, Shen J, Forrester JD. Xanthogranulomatous inflammation requiring small bowel anastomosis revision: A case report.
World J Gastrointest Surg 2023;
15:488-494. [PMID:
37032803 PMCID:
PMC10080595 DOI:
10.4240/wjgs.v15.i3.488]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/15/2023] [Accepted: 02/16/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND
Xanthogranulomatous inflammation (XGI) is an uncommon process involving an accumulation of inflammatory cells, commonly lipid-laden macrophages. XGI has been described to occur throughout the body but only rarely in the lower gastrointestinal tract. We describe a case of XGI contributing to chronic obstructive symptoms in the terminal ileum, in which the patient had an initial diagnostic laparoscopy, continued to have symptoms, then proceeded to have the definitive treatment. To our knowledge, this is the first report of XGI associated with a prior small bowel anastomosis.
CASE SUMMARY
We report the case of a 42-year-old female who presented with intermittent epigastric pain and subjective fevers. She had undergone a laparoscopic small bowel resection for Meckel’s diverticulum five years prior. Her workup was notable for computed tomography scan demonstrating mild inflammation and surrounding stranding at the level of the prior anastomosis. She underwent a laparotomy, resection of the prior anastomosis and re-anastomosis, with final histopathological examination findings consistent with mural XGI.
CONCLUSION
XGI can occur at the site of a prior bowel anastomosis and cause chronic obstructive symptoms.
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