Two Cases of Emergency Operation due to Secondary Amyloidosis

Naoki Nishiwaki, Makoto Kataoka, Yoshiyuki Kuwabara, Hiroyuki Kawamura, Masami Mitani, Atsushi Sato, Akira Masaoka

Second Department of Surgery, Nagoya City University Medical School

Amyloidosis is a metabolic disease characterized by the extracellular deposition of amyloid protein which causes widespread damage to the gastrointestinal tract. Emergency surgery for amyloidosis is rare, with only 18 reported cases. We report two such cases. In case 1 the patient was a 53-year-old male with a history of rheumatoid arthritis. An emergency operation was carried out for general peritonitis due to intestinal perfortion. In case 2 the patient was a 72-year-old male, also with a history of rheumatoid arthritis. An emergencyoperation was carried out for ileus. Amyloidosis is a systemic disease. At the operation for amyloidosis, damage to the heart, kidney and liver was found to cause a high mortality rate. According to a statistical study of fatal cases of rheumatoid arthritis, gastric ulcers hare recently decreased but amyloidosis is increasing to become the third cause of death. These two cases showed that establishment of therapy for amyloidosis was necessary.

Key words
amyloidosis, intestinal obstruction, ischemic necrosis of the intestine

Reprint requests
Naoki Nishiwaki The Department of Surgery, Toyota Memorial Hospital
1 Heiwachoi, Toyota City, 471 JAPAN

Accepted
December 11, 1996

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