SMALL INTESTINAL PERFORATION DUE TO SECONDARY AMYLOIDOSIS IN A PATIENT UNDER LONG-TERM HEMODIALYSIS

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  • ISHIGURO Kaname
    Department of General and Gastroenterological Surgery, Ishikawa Prefectural Central Hospital
  • BANDOU Hiroyuki
    Department of General and Gastroenterological Surgery, Ishikawa Prefectural Central Hospital
  • KOTAKE Masanori
    Department of General and Gastroenterological Surgery, Ishikawa Prefectural Central Hospital
  • YAMADA Tetsuji
    Department of General and Gastroenterological Surgery, Ishikawa Prefectural Central Hospital

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  • 長期血液透析患者に発症した続発性アミロイドーシスによる小腸穿孔の１例

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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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