Large-bowel Perforation Caused by Cytomegalovirus Enteritis during Long-term Steroid Treatment for Polymyositis

DOI Web Site 8 References

Bibliographic Information

Other Title
  • 多発筋炎に対するステロイド治療中にサイトメガロウイルス腸炎による大腸穿孔を来した1例

Search this article

Abstract

The patient was a 70-year-old woman who had been undergoing steroid and warfarin treatment for five years after being given a diagnosis of polymyositis and atrial fibrillation. She had a two-week history of hematochezia, but did not visit our hospital before the symptoms of sudden lower abdominal pain began. She presented deep tenderness and rebound tenderness in her left lower abdomen. Contrast-enhanced CT examination of the abdomen revealed a pneumoperitoneum, suggestive of gastrointestinal perforation, and an emergency laparotomy was performed. Exploratory laparotomy revealed a perforation approximately 5 mm in diameter in the sigmoid colon. Therefore, we resected the perforated segment of the colon and performed a colostomy. Several ulcers were observed in the mucosa of the sigmoid colon, which was exposed for the colostomy. As the patient was under long-term steroid treatment, cytomegalovirus (CMV) enteritis was suspected; she was put on a 3-week course of ganciclovir. The postoperative progress was favorable and the patient was discharged on the 28th day of hospitalization. CMV inclusion bodies were detected in the pathological examination of the resected segment. To the best of our knowledge, no previous reports of cases of intestinal perforation caused by CMV enteritis during treatment for polymyositis have been published. When patients undergoing immunosuppresive therapy suffer gastrointestinal perforation, CMV enteritis should be suspected and early treatment with antiviral agents should be considered.

Journal

References(8)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top