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13670 Surgery

A 25 year old man presents to the emergency room with severe abdominal pain. Guaiac test on stool demonstrates occult blood. The patient is taken to exploratory laparotomy, at which a small area of infarcted small bowel is found and surgically removed. Histologic studies on the removed section of bowel demonstrate a recent thrombus occluding a small muscular aery. The adjacent vessel wall shows fibrinoid necrosis with a mixed inflammatory infiltrate containing neutrophils, eosinophils, and mononuclear cells. Which of the following is the most likely cause of the small bowel infarction?

AAtherosclerosis
BCystic medial necrosis
CMonckeberg's aeriosclerosis
DPolyaeritis nodosa
Surgery
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