Gangrenous Ischemic Colitis of the Rectum Associated with Systemic Lupus Erythematosus

Abstract

Systemic lupus erythematosus (SLE) patients, especially those with antiphospholipid antibodies, have a high incidence of arterial and venous thrombotic manifestations. However, ischemic colitis with colonic necrosis (ICN) has been rarely reported in these patients.
We describe here a 53-year-old woman complicated with ICN and presenting with sudden onset of massive rectal bleeding. Proctoscopy and abdominal X-ray indicated that she had gangrenous ischemic colitis and perforation of the rectum. She underwent emergency laparotomy, proximal sigmoid colonostomy was subsequently performed and necrotic part of rectum was covered by distal sigmoid colon and adnexa.
This is the second report of gangrenous ischemic colitis isolated to the rectum. The incidence and significance of ICN associated with SLE are discussed.