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Jejunal perforation complicating dermatomyositis
Donghyoun Lee1, Woo Seong Jeong2, Chang Lim Hyun3
1Department of Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju Self-governing Province, South Korea.
International Journal of Surgery Case Reports
|November 18, 2019
Summary
Small bowel perforation is a rare but serious complication of dermatomyositis (DM). Early diagnosis and treatment are crucial for improving outcomes in these patients.
Area of Science:
- Gastroenterology
- Rheumatology
- Surgical Pathology
Background:
- Small bowel perforation is an infrequent complication in dermatomyositis (DM).
- This condition carries significant morbidity and mortality rates.
- This case report adheres to the SCARE criteria for clinical case reporting.
Purpose of the Study:
- To present a case of jejunal perforation in a patient with dermatomyositis.
- To highlight the diagnostic challenges and management of this rare complication.
Main Methods:
- A 63-year-old female patient with a history of DM treated with high-dose steroids presented with acute abdominal pain.
- Computed tomography (CT) revealed pneumoperitoneum and small bowel fluid, indicating perforation.
- Emergency laparotomy was performed, revealing a perforated jejunum which was surgically resected.
Main Results:
- Pathological examination confirmed mesenteric small-vessel vasculitis with perivascular inflammation.
- The patient underwent surgical resection of the perforated jejunum.
Conclusions:
- Small bowel perforation in DM patients is rare and can be challenging to diagnose due to overlapping gastrointestinal symptoms.
- Prompt diagnosis using imaging modalities like CT, alongside clinical history, is vital.
- Timely surgical intervention is essential to reduce mortality in DM-associated bowel perforation.
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