Two Cases of Gastrointestinal Tract Perforation in Amyloidosis

Itasu Ninomiya, Genichi Nishimura, Hidenori Hashimoto, Akitaka Nonomura*

Department of Surgery, Naruwa General Hospital
*Pathology Section, Kanazawa University Hospital

We encountered two cases of gastrointestinal tract perforation due to amyloidosis. The first patient was a 56-year-old man who had been treated by hemodialysis three times a week for 19 years for chronic renal failure. An emergency laparotomy, performed under a diagnosis of perforating peritonitis, revealed perforation of about 1 cm in the sigmoid colon. The sigmoid colon including the perforated site was resected. Histopathological examination showed severe deposition of β2-microglobuoin as amyloid protein in the tunica muscularis and vessel walls of the submucosa. This amyloid protein deposition may be caused by long-term insufficient hemodialysis. The second patient was a 68-year-old man who was diagnosed with perforating peritonitis 6 days after nephrectomy because of a right small renal cell carcinoma. An emergency operation revealed a spontaneous perforation of about 5 mm in the jejunum. Histopathological examination showed deposition of the light chain of immunoglobulin as amyloid protein in the perivascular tissue of the kidney and the jejunum. A post operative general examination suggested primary amyloidosis.

Key words
amyloidosis, perforation of gastrointestinal tract

Reprint requests
Itasu Ninomiya Department of Surgery II, School of Medicine, Kanazawa University
13-1 Takaramachi, Kanazawa, 920 JAPAN

Accepted
June 8, 1994

To read the PDF file you will need Abobe Reader installed on your computer.