Ileal perforation as an initial manifestation of systemic lupus erythematosus: A case report.

Autor:	Shrestha BM; Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal. Electronic address: bibekmanstha7@gmail.com., Shrestha S; Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal., Kharel S; Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal., K C A; Department of GI and Hepatobilliary Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Shrestha S; Department of GI and Hepatobilliary Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Pradhan S; Department of GI and Hepatobilliary Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal., Bhandari RS; Department of GI and Hepatobilliary Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2021 Oct; Vol. 87, pp. 106409. Date of Electronic Publication: 2021 Sep 15.
DOI:	10.1016/j.ijscr.2021.106409
Abstrakt:	Introduction and Importance: Lupus enteritis is uncommon in patients with SLE and usually presents with anorexia, vomiting, and abdominal pain. Intestinal perforation as an initial manifestation of SLE is rare and can have a grave prognosis if not timely diagnosed. Case History: We report an unusual case of a 22-year-old regularly menstruating female who presented with features of perforation peritonitis as an initial manifestation of lupus enteritis. Intraoperatively, a gangrenous ileal segment with multiple perforations was present. Thus, with an intraoperative diagnosis of perforation peritonitis, a gangrenous segment of the small bowel was resected and a double-barrel jejuno-ileostomy was created. Discussion: Lupus enteritis manifesting initially as bowel perforation can be an uncommon cause of acute abdomen. A plain chest X-ray can show gas under the diaphragm suggesting bowel perforation. A contrast-enhanced CT scan of the abdomen is the gold standard in diagnosing lupus enteritis with a good prognosis on steroids. Conclusion: Primary closure, resection, and anastomosis of small gut or diverting stoma are required for management of perforation. A high degree of clinical suspicion is required for early diagnosis thus preventing the grave prognosis of such an entity. (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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