A Case Report of Intestinal Perforation Causing by Dialysis-Related Amyloidosis

Takashi Tsuji, Terumitsu Sawai, Shinichi Shibasaki, Atsushi Nanashima, Masaaki Jibiki, Hiroyuki Yamaguchi, Tohru Yasutake, Tohru Nakagoe, Hiroyoshi Ayabe and Kuniko Abe^*

First Department of Surgery, Nagasaki University School of Medicine, Department of Pathology, Nagasaki University Hospital^*

We experienced a case with an intestinal perforation resulting from dialysis-related amyloidosis. A fifty-six-year old women who had been receiving hemodialysis for twenty-three years underwent an operation for bilateral carpal tunnel syndrome and destructive spondyloarthropathy. She had experienced the onset of diarrhea four months earlier, and was operated on for perforative peritonitis. The middle part of the small intestine contained a 16×8 mm hole. Partial resection of the small bowel and end-to-end anastomosis was performed. A pathological examination revealed an amyloid deposit in a perivascular area of the submucosal layer, and immunohistochemistry for β2-microglobulin was positive. She was diagnosed as having dialysis-related amyloidosis. Anastomotic leakage occurred early during the post-operative day. She was died five months later because of a sepsis.

Key words
dialysis-related amyloidosis, intestinal perforation, β2-microglobulin

Reprint requests
Takashi TsujiFirst Department of Surgery, Nagasaki University School of Medicine 1-7-1 Sakamoto-machi, Nagasaki City, 852-8501 JAPAN

Accepted
October 31, 2001

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