Ileal perforation as an initial manifestation of systemic lupus erythematosus: A case report
| Autor: | Ramesh Singh Bhandari, K C Ajay, Sumita Pradhan, Bibek Man Shrestha, Sujan Shrestha, Sanjeev Kharel, Suraj Shrestha |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Abdominal pain Ileal Perforation Systemic lupus erythematosus business.industry Perforation (oil well) SLE Peritonitis Case Report medicine.disease Lupus enteritis Enteritis Surgery Gangrene medicine.anatomical_structure Acute abdomen medicine Abdomen Intestinal perforation medicine.symptom business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2021.106409 |
| Popis: | 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. Highlights • Bowel perforation in patients with SLE is rare. • Diagnosis of this lupus enteritis is challenging owing to its rarity and non-specific presenting features. • High degree of suspicion and timely diagnosis can prevent fatal complications. |
| Databáze: | OpenAIRE |
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