A Case Of Systemic Lupus Erythematosus Complicated with Perforations of the Colon

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  • 大腸穿孔をきたしたSLEの1例

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Abstract

A 74-year-old man was diagnosed as having systemic lupus erythematosus at 71 years of age and oral steroid treatment had been administered since then. In early August 2002, he felt hot and developed a fever (4°C). In mid-August 2002, he was referred to our hospital. At admission, he had right lower abdominal pain and right back pain. Laboratory examinations revealed inflammation, and a fecal occult blood test was positive (3+). CT scans showed retroperitoneal gas behind the descending colon. Colonoscopy indicated perforations of the descending colon. An emergency laparotomy was performed and showed purulent ascites, a dilated edematous descending colon including partial necrosis with perforation and a large retroperitoneal abscess. Left hemicolectomy, transverse colostomy, abdominal drainage and retroperitoneal drainage were carried out. The resected specimen showed three punched out perforations. Histological findings revealed acute inflammation around the perforations, but no evidence of specific arteritis or vasculitis. The patient ’ s postoperative course was uneventful and oral steroids were administered for the SLE. He was subsequently discharged.

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