Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Online ISSN : 1882-5133
Print ISSN : 1345-2843
ISSN-L : 1345-2843
Clinical Studies
Small intestinal perforation due to secondary amyloidosis in a patient under long-term hemodialysis
Kaname ISHIGUROHiroyuki BANDOUMasanori KOTAKETetsuji YAMADA
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2008 Volume 69 Issue 7 Pages 1678-1682

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Abstract
The gastrointestinal tract is a siteprone to amyloid deposition, but this has rarely been reported to cause perforation of the gastrointestinal wall. We report a case of small bowel perforation due to dialysis amyloidosis. A 68-year-old woman who had been under hemodialysis for 30 years visited our hospital with a chief complaint of fever. She was diagnosed as having peritonitis due to a gastrointestinal perforation and underwent surgery. A segment of the ileum at 20cm proximal to the ileocecal junction was necrotic and ileostomy was performed. Histopathological examination led to a diagnosis of ileal necrosis due to dialysis amyloidosis. Following surgery, the patient received intensive care and her general condition improved. This case highlights the need for renewed awareness regarding long-term dialysis as a risk factor for gastrointestinal perforation.
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© 2008 Japan Surgical Association
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