Pre-operative radiological diagnosis of acute necrotizing enteritis in systemic lupus erythematodes

Acute abdominal complications of systemic lupus erythematodes requiring laparatomy are not frequent. A 30-year-old man with systemic lupus erythematodes developed a necrotizing enteritis of the small bowel with pneumatosis intestinalis. Only one case of intestinal vasculitis associated with systemic lupus erythematodes has previously been reported. Presence of intramural gas in the small bowel and of gas in the portal vein was detected on plain abdominal film and confirmed by subsequent CT examination. Since corticosteroids often mask the severity of the disease, radiological evaluation is essential to the overall management of the patient with intestinal vasculitis. Due to the observed radiological signs, emergency laparotomy was performed. Histologic examination revealed necrotizing enteritis due to vasculitis.