A Case of Small Intestinal Perforation in Amyloidosis

Hisayasu Aoki, Seiji Miura, Kanji Mieno, Yutaka Satoi, Yoshitsugu Takeda, Kenjirou Amino, Akihisa Nemoto, Fumitoshi Horie, Jun-ichi Shikata

The First Department of Surgery, Teikyo University School of Medicine

Although amyloidosis of the digestive tract is relatively common, few patients develop perforating peritonitis. An 82-year-old woman consulted us with abdominal pain and bloody stool. An X-ray showed free gas, and laparotomy, performed under a diagnosis of perforating peritonitis, revealed perforation at 3 sites of the ileum. The histopathological diagnosis was AL-type amyloidosis. Postoperative general examinations suggested secondary amyloidosis. The perforation is believed to have been caused by some stimulation such as amyloid deposition in small vessels of the intestinal wall, inducing regional ischemic changes and increase in vascular vulnerability.

Key words
Amyloidosis, perforation, small intestine

Reprint requests
Hisayasu Aoki First Department of Surgery, Teikyo University School of Medicine
2-11-1 Kaga, Itabashi-ku, Tokyo, I73 JAPAN

Accepted
July 10, 1990

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