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Relapsing retroperitoenal abscess secondary to juvenile dermatomyositis: Complexity in management

M Jothinathan1, K S Lau2, D Vanusha3

  • 1Sarawak General Hospital, Department of Surgery, Kuching, Sarawak, Malaysia. jothinathan84@gmail.com.

The Medical Journal of Malaysia
|April 14, 2020
PubMed

Insights

Juvenile dermatomyositis (JDM) can rarely cause severe gastrointestinal issues like colon perforation. Early recognition and management are crucial for these challenging cases.

Area of Science:

  • Rheumatology
  • Gastroenterology
  • Autoimmune Diseases

Background:

  • Juvenile dermatomyositis (JDM) is a rare autoimmune disorder primarily affecting muscles.
  • Gastrointestinal and pulmonary complications are infrequent but serious manifestations of JDM.
  • Gastrointestinal perforation in JDM is linked to underlying vasculopathy and ischemia.

Observation:

  • A 21-year-old male with JDM presented with spontaneous descending colon perforation.
  • The patient underwent a Hartmann's procedure for the perforation.
  • He later developed recurrent retroperitoneal abscesses, managed with percutaneous drainage.

Findings:

  • This case highlights a rare presentation of JDM with a critical gastrointestinal complication.
  • Management of JDM-associated gastrointestinal perforation is complex and requires multidisciplinary care.
  • Recurrent abscess formation necessitates vigilant follow-up and timely intervention.

Implications:

  • A high index of suspicion for acute abdominal conditions is vital in JDM patients.
  • Understanding the link between JDM, vasculopathy, and GI complications is important for clinicians.
  • Further research into the optimal management strategies for JDM with GI involvement is warranted.

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