A Case of Degos Disease without Macroscopic Gastrointestinal Perforation

Munenori Nagao, Yuji Funayama, Hiroo Naito¹⁾, Kouhei Fukushima, Chikashi Shibata, Kenichi Takahashi, Akihiko Hashimoto, Takuya Moriya²⁾, Yukikazu Numata³⁾ and Iwao Sasaki

Department of Surgery, Division of Biological Regulation and Oncology (GI & Colorectal Surgery), Tohoku University Graduate School of Medicine,
¹⁾South-Miyagi Medical Center
²⁾Department of Pathology, Tohoku University Hospital
³⁾Department of Dermatology, Tohoku University Graduate School of Medicine

A 25-year-old woman with typical itch-free red papulae from August 1999 was diagnosed with Degos disease. She took oral aspirin from then on, but reported abdominal discomfort in April 2001. We undertook laparotomy based on suspected diffuse peritonitis due to gastrointestinal perforation. Serobloody, purulent massive ascites had accumulated in the peritoneal cavity, and inflammation was observed along the entire small intestine. Despite marked dilation, no macroscopic perforation was seen in the small intestine. We conducted construction of a loop ileostomy for intestinal decompression, but she died of sepsis on postoperative day 91. Multiple inflammatory lesions were observed in the small intestine at autopsy, but no perforation was apparent macroscopically.

Key words
Degos disease (malignant atrophic papulosis), surgery, intestinal perforation

Reprint requests
Munenori Nagao Department of Surgery, Division of Biological Regulation and Oncology, Tohoku University Graduate School of Medicine
1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 JAPAN

Accepted
October 29, 2003

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