Acute abdomen in rheumatoid arthritis due to mesenteric arteritis. A case report and review

A 69-year-old woman with seropositive rheumatoid arthritis since the age of 54 developed severe abdominal pain, and laparotomy was performed. Due to perforation of the ileum, there was generalised peritonitis. The histological examination showed mesenteric rheumatoid arteritis. Only a few cases like this are described in the literature. Most of the patients were males, and the mortality was high. When a patient with rheumatoid arthritis develops abdominal pain, mesenteric arteritis may be the cause. No definitive therapy is available, but prompt surgical intervention followed by anticoagulants has been recommended. For the treatment of rheumatoid vasculitis as such, corticosteroids in high doses, cyclophosphamide and plasma exchange have been used separately with beneficial effects.