Abstract
We present here the case of a patient with allergic granulomatous angitis (AGA) who had two small intestine perforations in a short interval, and we reviewed 11 cases, including our own, of AGA with accompanying gastrointestinal perforations reported so far in Japan. Our case was a twenty-three yeat old man who had been treated with steroid hormone in an outpatient clinic. He re-entered our hospital complaining of severe abdominal pain. At first admission, there had been no evidence of parasite disease, and this time, we found severe duodenal erosion on upper gastrointestinal endoscopy. Abdominal angiography revealed stenotic and tapering changes probably due to angitis in both the superior and inferior mesenteric arteries. Steroid pulse theapy was not effective in reducing the severity of abdiminal pain, but the administration of a large amount of PGE_1 was very effective. In spite of the therapy, the patient had small intestine perforations on his 27th day in hospital and two months thereafter, and was operated on twice. The death rate in AGA patients with accompanying gastrointestinal peforations is relatively high in our country, and 2 out of 11 cases had recurrent perforations. Therefore, it is considered essential to pay great attention to abdominal manifestations in AGA patients.
