A Case of Colon Ileus due to Vasculitis in Malignant Rheumatoid Arthritis

Susumu Yamamura, Kengo Ikeda, Tadashi Kobayashi, Masaaki Kobayashi, Itsuo Fujita*, Shigeki Yokomuro* and Eiji Uchida*

Department of Surgery, Kobayashi Hospital
Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine*

A 38-year-old man admitted for abdominal pain and having a history of ileus due to a jejunal internal hernia and rheumatism. He was discharged after 13 days when no findings of suspected ileus were seen and his abdominal pain subsided. Two months later, when abdominal pain reoccurred, he was diagnosed with ileus. The sigmoid colon wall was thickened and completely stenotic, necessitating surgery. Postoperatively, anastomosis sutures ruptured, necessitating single- foramen stoma construction. Histopathologically, ischemic ulceration due to vasculitis of Endoarteritis (EA) occured mainly on the subserosa at the resection specimen of a narrow segment. Vasculitis in malignant rheumatoid arthritis is thought to have caused ulceration at colon, triggering ileus.

Key words
malignant rheumatoid arthritis, ileus, vasculitis

Reprint requests
Susumu Yamamura Department of Surgery, Kobayashi Hospital
3-10-8 Narimasu, Itabashi-ku, 175-0094 JAPAN

Accepted
November 18, 2009

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