A Case of Lupus Mesenteric Vasculitis Resulting in Small Bowel Infarction / 대한류마티스학회지

ABSTRACT

Systemic lupus erythematosus(SLE) is an autoimmune disease involving many organs. Mesenteric vasculitis is one of the serious organ involvement in this disease. Mesenteric vasculitis may produce mucosal ulceration, bowel edema with paralytic ileus, hemorrhagic ileitis, intussusception, perforation and mesenteric infarction. Because of high mortality rate, early diagnosis and treatment of this manifestation is very important. We experienced a case of SLE with extensive smell bowel infarction due to mesenteric vasculitis. She was 29 years old. She was suffered frem severe abdominal pain for three days. Abdominal computed tomography showed diffusse wall thickening of the small intestinal wall. After high dose intravenous steroid, her abdominal symptoms were improved. She was discharged with low dose oral steroid(15mg/day) treatment. Seven months later, she presented with sudden abdominal pain. Intravenous methylprednisolon(2mg/Kg) was started. Three days later, her abdominal symptoms were not subsided. On the plain radiograph of the abdomen, marked ileus was demonstrated. Mesenteric angiography showed diffuse decreased small bowel vascularity. A provisional diagnosis of small bowel infarction and obstruction, we performed exploratory laparotomy. She undergone small bowel segmental resection. The diagnosis was small bowel infaction due to mesenteric vasculitis.