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Abdominal computed tomography in lupus mesenteric arteritis.

D M Kirshy1, D H Gordon, N A Atweh

  • 1Department of Radiology, State University of New York, Brooklyn 11203.

Computerized Medical Imaging and Graphics : the Official Journal of the Computerized Medical Imaging Society
|September 1, 1991
PubMed
Summary

Systemic lupus erythematosus can cause acute abdomen due to mesenteric arteritis. Computed tomography (CT) revealed bowel wall thickening, which resolved after steroid treatment, marking the first CT demonstration of lupus mesenteric arteritis before and after therapy.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Rheumatology

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
  • Mesenteric arteritis is a potential complication of SLE, leading to abdominal pain and bowel ischemia.
  • Computed tomography (CT) is a key imaging modality for diagnosing abdominal pathologies.

Observation:

  • A patient with SLE presented with symptoms of an acute abdomen.
  • Initial abdominal CT scans showed ascites and thickening of the duodenum and jejunum walls.
  • Mesenteric vessels appeared prominent on imaging.

Findings:

  • The CT findings were consistent with lupus mesenteric arteritis causing bowel ischemia.
  • After treatment with high-dose intravenous steroids, follow-up CT scans showed normalization of the duodenum and small bowel.

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  • This case represents the first surgically proven instance of lupus mesenteric arteritis with CT evidence before and after medical intervention.

    • Implications:

    • Lupus mesenteric arteritis should be considered in the differential diagnosis of bowel wall thickening and ischemia, particularly in SLE patients.
    • CT imaging plays a crucial role in identifying and monitoring lupus mesenteric arteritis.
    • Early diagnosis and treatment with corticosteroids can lead to favorable outcomes, avoiding surgical intervention.