Ischemic necrosis with sigmoid perforation in a patient with Systemic Lupus Erythematosus (SLE): case report

• Published in: Il Giornale di chirurgia 2012-03, Vol.33 (3), p.77-80
• Main Authors: Iannella, I, Candela, S, Di Libero, L, Argano, F, Tartaglia, E, Candela, G
• Format: Article
• Language: English
• Subjects: Adult; Female; Humans; Intestinal Perforation - etiology; Intestinal Perforation - pathology; Intestinal Perforation - surgery; Ischemia - etiology; Ischemia - pathology; Ischemia - surgery; Lupus Erythematosus, Systemic - complications; Necrosis; Peritonitis - etiology; Polyarteritis Nodosa - complications; Polyarteritis Nodosa - etiology; Reoperation; Sigmoid Diseases - complications; Sigmoid Diseases - etiology; Sigmoid Diseases - pathology; Sigmoid Diseases - surgery; Treatment Outcome
• ISSN: 0391-9005

Systemic Lupus Erythematosus (SLE) is a chronic inflammatory rheumatic disease which affects the connective tissue. Its etiology is as yet unknown, while its pathogenesis involves the immune system. Both genetic and environmental and hormonal factors play a key role in the impaired immune regulation. A correlation with estrogens is demonstrated by the fact that the greatest incidence is found in young women, when estrogen secretion is at its highest. The disease is also reported to worsen in women taking oral contraceptives. It is therefore believed that the components of oral contraceptives, estrogens (ethinyl estradiol) and progestins, can affect the immune profile. Of the various complications attributed to systemic lupus erythematosus, gastrointestinal disorders are less common but potentially by far the most serious. We report a case of ischemic necrosis with sigma perforation in a patient with SLE. Signs and symptoms of acute abdomen in patients with SLE are rare (0.2%), but serious. Most patients require an exploratory laparotomy, as the causes are often linked with vasculitis.