Scleroderma of the colon presenting with acute abdominal symptoms

A 66-year-old woman with long-standing systemic sclerosis presented with fever, acute abdominal pain and tenderness. She was treated with antibiotics. At laparotomy six weeks later, a narrow, stiff, friable and fibrotic right colon was found with histological features of scleroderma. The acute attack was interpreted as an ischaemic episode of the colon which later healed by fibrosis.