case_images: PMC10196535_01
case_images: (a, b) The patient was found to have multiple punctate lesions of
  full-thickness necrosis every few centimeters throughout the colon, most
  prominently in the ascending colon (black arrows).
case_images: 10.1177_2050313X231175295-fig1.jpg
case_images: PMC10196535_01_10.1177_2050313X231175295-fig1.jpg
case_images: fig1-2050313X231175295
case_images: On take back, the patient was found to have multiple punctate lesions of full-thickness necrosis every few centimeters throughout the colon, most prominently in the ascending colon (Figure 1).
case_images: Macroscopic examination after formalin fixation reveals transmural
  elliptical-shaped perforations were noted 12 cm from the proximal margin
  with nearby areas of ulceration (black arrows).
case_images: 10.1177_2050313X231175295-fig2.jpg
case_images: PMC10196535_01_10.1177_2050313X231175295-fig2.jpg
case_images: fig2-2050313X231175295
case_images: Upon gross examination, full-thickness transmural elliptical-shaped perforations were noted 12 cm from the proximal margin with nearby areas of ulceration (Figure 2).
case_images: Focus of ulceration with granulation tissue (black arrows).
case_images: 10.1177_2050313X231175295-fig3.jpg
case_images: PMC10196535_01_10.1177_2050313X231175295-fig3.jpg
case_images: fig3-2050313X231175295
case_images: Microscopic examination confirmed the presence of multiple foci of ulceration with granulation tissue as well as scattered medium and small-sized vessel vasculitis, consistent with the patient's known Buerger's disease (Figures 3 and 4).
case_images: (a) Vasculitis (20x magnification), (b) arteritis (40x magnification), and
  (c) venulitis (40x magnification).
case_images: 10.1177_2050313X231175295-fig4.jpg
case_images: PMC10196535_01_10.1177_2050313X231175295-fig4.jpg
case_images: fig4-2050313X231175295
case_images: Microscopic examination confirmed the presence of multiple foci of ulceration with granulation tissue as well as scattered medium and small-sized vessel vasculitis, consistent with the patient's known Buerger's disease (Figures 3 and 4).
case_images: (a, c) Mucosal ulcer with vasculitis (black arrows, 4x and 10x magnification,
  respectively). (b, d) Elastic special stain highlights the involved vessels
  (black arrows, 4x and 10x magnification, respectively).
case_images: 10.1177_2050313X231175295-fig5.jpg
case_images: PMC10196535_01_10.1177_2050313X231175295-fig5.jpg
case_images: fig5-2050313X231175295
case_images: Grocott's methianine silver special stain for fungi was negative and elastic stain highlighted the involved vessels (Figures 5 and 6).
case_images: (a) Vasculitis (arteritis) almost occluded (40x magnification) with elastin
  staining shown in (b, c). Venulitis (20x magnification) with elastin
  staining shown in (d).
case_images: 10.1177_2050313X231175295-fig6.jpg
case_images: PMC10196535_01_10.1177_2050313X231175295-fig6.jpg
case_images: fig6-2050313X231175295
case_images: Grocott's methianine silver special stain for fungi was negative and elastic stain highlighted the involved vessels (Figures 5 and 6).