Systemic Lupus Erythematosus with Rectal Perforation, Report of a Case Masahiro Igarashi 1 , Tomoe Katsumata 1 , Kiyonori Kobayashi 1 , Katsunori Saigenji 1 , Eio Atari 3 1Department of Internal Medicine, Kitasato University East Hospital 3Department of Pathology, Kitasato University East Hospital Keyword: SLE , 直腸潰瘍 , 穿孔 pp.1285-1290
Published Date 1991/11/25
DOI https://doi.org/10.11477/mf.1403102694
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 A 31-year―old female was admitted to our hospital with constipation and abdominal pain. She had been treated with corticosteroid due to systemic lupus erythematosus (SLE) since eleven years previously. Endoscopic findings showed multiple rectal ulcers that were of punched-out shape and distinct, with normal surrounding mucosa. Perforation occurred after about three weeks of therapy with intravenous hyperalimentation. The histopathological findings of the resected specimen demonstrated circumscribed ulcer (3.5×7.2cm) with perforation (0.4×0.2cm) and small ulcer (1.4×2.0cm). Vascular occlusion with vasculitis, thrombosis and sclerotic changes were shown in the arteries and veins under the subserosal layer. It is concluded that the pathogenesis of the ulcers was due to circulation disturbances, and long term steroid therapy had promoted vascular sclerosis.

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