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Pitfalls in familial mediterranean fever: acute intestinal strangulation/obstruction due to primary adhesions
E d'Annunzio1, N Chafai, E Tiret
1Service de chirurgie générale et digestive, hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Abstract:
Familial Mediterranean Fever (FMF) presents in 90% of patients with painful attacks of peritoneal inflammation, which may mimic an acute surgical abdomen. These episodes characteristically resolve spontaneously within 72 hours. However, recurrent episodes of primary peritonitis may lead to the development of primary intraperitoneal adhesions, even in the absence of previous abdominal surgery. When an atypical bout of pain fails to resolve spontaneously and rapidly, the surgeon must consider the diagnosis of intestinal obstruction due to an adhesive band with the associated risk of strangulation with bowel necrosis. In this case report, we describe this rare but classical presentation of FMF for which any delay in diagnosis or treatment may result in severe morbidity.
Insights
Familial Mediterranean Fever (FMF) can cause abdominal pain mimicking surgical emergencies. Recurrent FMF attacks may lead to adhesions, causing intestinal obstruction and necrosis if misdiagnosed.
Area of Science:
- Internal Medicine
- Gastroenterology
- Genetics
Background:
- Familial Mediterranean Fever (FMF) commonly causes recurrent peritoneal inflammation.
- These inflammatory episodes can mimic acute surgical abdomen, leading to potential misdiagnosis.
- Chronic FMF may result in intraperitoneal adhesions, independent of prior abdominal surgery.
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