A Rash Case of Secondary Gastrointestinal Amyloidosis Sent to Our Hospital Under a Diagnosis of Bowel Obstruction

Masahiro Hirose^{1) 2)}, Yasuo Nanba²⁾, Tsutoshi Murakami²⁾, Yoshihiro Yamamoto²⁾, Teizou Inoue²⁾, Takayuki Urushihata²⁾ and Yasuhiro Fujiwara²⁾

¹⁾Department of Surgery, Nomura Town Hospital
²⁾Department of Surgery, Kousei General Hospital

Gastrointestinal amyloidosis is a metabolic disease characterized by the deposition of amyloid proteins in the wall of the gastrointestinal tract, and causes symptoms such as abdominal pain, vomiting, and diarrhea. Surgical treatment is indicated for acute bowel obstruction, perforation and hemorrhage, and so on. This disease arises secondarily to chronic wasting diseases, such as rheumatoid arthritis (RA), renal failure, and so on. We recently encountered the case of a 62-year-old woman with gastrointestinal amyloidosis secondary to RA, in which diagnosis and treatment were difficult. Retrospectively, this case is now considered a typical gastrointestinal amyloidosis judging from clinical history and abdominal X-ray films showing many gaseous shadows, in which diagnosis was relatively easy and prompt treatment was desired. When we diagnose a patient who has acute abdomen or gastrointestinal symptoms with clinical histories of RA and/or hemodialysis, etc., we must consider secondary gastrointestinal amyloidosis, and if surgical treatment is not indicated, we must make a quick decision to refer the patient to a specialist for amyloidosis without delay.

Key words
acute abdomen, secondary gastrointestinal amyloidosis, rheumatoid arthritis

Reprint requests
Masahiro Hirose Department of Surgery, Kousei General Hospital 3-3-28 Minami, Mihara-shi, 723-8686 JAPAN

Accepted
October 26, 1999

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