Page 303 - The Vasculitides, Volume 1: General Considerations and Systemic Vasculitis

In: The Vasculitides, Volume 1 ISBN: 978-1-63463-110-5
Editors: David S. Younger © 2015 Nova Science Publishers, Inc.

Chapter 15

Systemic Vasculitis of the
Gastrointestinal Tract

Dimitri Chanouzas, M.R.C.P., M.Sc. and
Matthew David Morgan, M.B., Ch.B., M.R.C.P., Ph.D.?

Renal Immunobiology, Centre for Translational Inflammation Research,
School of Immunity and Infection,

College of Medical and Dental Sciences,
University of Birmingham, Birmingham, UK

Abstract

Systemic vasculitides are a cause of vascular inflammation throughout the body
including the gastrointestinal tract.

The nature of its involvement depends on the size and location of the affected
vessels. Involvement of large vessels typically leads to downstream ischemia and tissue
infarction.

Medium vessel involvement can cause hemorrhage from ruptured aneurysms,
downstream ischemia and tissue infarction. Small vessel involvement typically leads to
ulceration, patchy infarction and bleeding. Severe GI involvement in systemic vasculitis
confers a worse prognosis.

Management of the underlying vasculitic process includes some form of
immunosuppression however surgical intervention to manage an intra-abdominal process
caused by the vasculitic process may also be necessary. Revascularization procedures
may be needed to manage aneurysm formation and to rescue ischemic tissue. This
chapter reviews GI involvement of primary and secondary vasculitic diseases and
outlines their management. Consideration will be given to gastrointestinal tract
complications due to immunosuppressive therapy of systemic vasculitis.

Keywords: Systemic, Vasculitis, Gastrointestinal, Autoimmunity

? Address for Correspondence: Matthew David Morgan, M.B., Ch.B., M.R.C.P, Ph.D., Centre for Translational
Inflammation Research, University of Birmingham Research Laboratories, Queen Elizabeth Hospital
Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB. Email: [email protected]

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