A Case of Systemic Lupus Erythematosus with Perforation of the Rectum

Tomoyoshi Suzuki, Kuniyoshi Arai, Yoshiaki Iwasaki, Soh Katayanagi, Keiichi Takahashi, Tatsuo Yamaguchi, Hiroshi Matsumoto and Hidenori Miyamoto

Department of Surgery, Tokyo Metropolitan Komagome Hospital

A 45-year-old man, who had been diagnosed as systemic lupus erythematosus (SLE), was admitted for high fever, vomiting and abdominal pain without remarkable development of disease activity of SLE. As intestinal perforation and pan-peritonitis was suspected with intraperitoneal free-air on abdominal CT scan, an emergency operation was perfomed. Laparotomy disclosed the perforation of the rectum, and recto-sigmoidectomy and colostomy (Hartmann's procedure) were carried out. Histological examination of the resected specimen showed the necrotizing ischemic colitis. He recoverd by intensive therapy including blood purification. Although intestinal perforation in SLE is a rare complication and only 23 patients have been reported to date in Japanese literature, mortality rate is high (39%). When a case of SLE with the abdominal complaints is encountered, we should pay attention to the life-threatening complication such as intestinal perforation.

Key words
SLE, intestinal perforation

Reprint requests
Tomoyoshi Suzuki Department of Surgery, Tokyo Metropolitan Komagome Hospital
3-18-22 Honkomagome, Bunkyo-Ku, Tokyo, 113-8677 JAPAN

Accepted
March 24, 2004

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