A case of sle patient with intestinal perforation due to necrotizing vasculitis

Abstract

The patient was a 56-year-old woman suffering from SLE for about 32 years. She visited our hospital with the chief complaint of lower abdominal pain. Since free air in the abdomen was detected by abdominal X-ray and CT scanning, perforation in the lower digestive tract was diagnosed, and laparotomy was performed. Retention of pyoascites was observed in the abdominal cavity and a perforation was detected in the lower ileum. Partial resection of the ileum with the perforated site was performed. Microscopic examination of the resected small intestine disclosed marked necrotizing vasculitis of small and medium-sized arteries with fibrinoid degeneration and inflammatory cell infiltration in and around the affected blood vessel walls were noted.
The patient survived the first operation, but the perforation of the colon and the different segment of the ileum occurred in different times and died due to the development of MOF.