2019, Number 5
Rev Fac Med UNAM 2019; 62 (5)
Radiological findings in pseudo-intestinal obstruction due to systemic lupus erythematosus. A case report
Bautista LJN, Mayo VFC, Calderón LLM
Language: Spanish
References: 10
Page: 11-15
PDF size: 224.34 Kb.
ABSTRACT
The pseudo-intestinal obstruction (PIO) is an uncommon
complication due to systemic lupus erythematosus (SLE) and
its diagnosis can be challenging, especially when trying to
differentiate it from other abdominal diseases. Clinical manifestations
are caused by muscular, vascular and nervous damage
of the intestinal walls, causing hypomotility and symptoms
of obstruction. This paper reports the case of a 19 year-old
woman who first manifested abdominal pain, abdominal
distention and vomits, plus she had a history of inferior vena
cava thrombosis and lupus. An abdominal computed tomography
(CT) scan showed intestinal distention, PIO, ascites
and right hydronephrosis, therefore the diagnosis of a
real obstruction was rejected, and surgical intervention was
avoided. The patient was treated with steroids. The response to the treatment was good, the patient went into remission,
and was discharged from the hospital. 12 months later, no
complications were reported. SLE with PIO is hard to detect,
but the proper identification and correlation of the semiology
of the case with the immunological and imaging data was
decisive in the differential diagnosis with other abdominal
diseases, such as the intestinal obstruction.
REFERENCES
Brewer BN, Kamen DL. Gastrointestinal and Hepatic Disease in Systemic Lupus Erythematosus. Rheum Dis Clin N Am. 2018;44(1):165-75.
Hallegua D, Venuturupalli S. Gastrointestinal and Hepatic Manifestations. En: Wallace DJ, Hahn B, Dubois EL, editores. Dubois’ lupus erythematosus and related syndromes. 8th ed. Philadelphia, PA: Elsevier/Saunders; 2013. p. 415-25.
Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, et al. Gastrointestinal system involvement in systemic lupus erythematosus. Lupus. Octubre de 2017;26(11):1127-38.
Merlin A, Soyer P, Boudiaf M, Hamzi L, Rymer R. Chronic intestinal pseudo-obstruction in adult patients: multidetector row helical CT features. Eur Radiol. agosto de 2008;18(8):1587-95.
Hill PA, Dwyer KM, Power DA. Chronic intestinal pseudoobstruction in systemic lupus erythematosus due to intestinal smooth muscle myopathy. Lupus. Julio de 2000;9(6):458-63.
Perlemuter G, Chaussade S, Wechsler B, Cacoub P, Dapoigny M, Kahan A, et al. Chronic intestinal pseudo-obstruction in systemic lupus erythematosus. Gut. 1 de julio de 1998;43(1):117-22.
Leonardi G. Intestinal pseudo-obstruction in inactive systemic lupus erythematosus: An unusual finding. World J Gastrointest Pharmacol Ther. 2010;1(6):135.
Qiao Z, Wang L, Chen Y, Feng H, Shen J. Systemic lupus erythematosus with intestinal pseudo-obstruction as initial manifestation in a middle-aged man: a case report and literature review. Int J Clin Exp Med. 2016;9:4.
Ceccato F, Salas A, Góngora V, Ruta S, Roverano S, Marcos JC, et al. Chronic intestinal pseudo-obstruction in patients with systemic lupus erythematosus: report of four cases. Clin Rheumatol. 2008;27(3):399-402.
López CAG. Intestinal pseudo-obstruction in patients with systemic lupus erythematosus: A real diagnostic challenge. World J Gastroenterol. 2014;20(32):11443.
Full text