[Wegener's granulomatosis: an often difficult diagnosis. Apropos of a case with digestive localization but without lung or kidney involvement]

Even if Wegener's disease is a rare condition, it interests many authors. Many recent reports had contributed to a best knowledge of the disease. Nevertheless, it persists a number of questions without yet an answer. In this paper, for example, we present a case of Wegener's granulomatosis, which mimics in the beginning the so-called "lethal midline granuloma", with progressive ulceration of the midfacial tissues and nose. It was highly suspected of being stewart's syndrome--Repeated biopsies gave no evidence of diagnosis. At least, the diagnosis was affirmed only by laparotomy. Pathological findings were typical of Wegener's granulomatosis with lesions interesting the sole digestive tract, lacking the characteristical chest and kidney involvement. The authors insist on the difficulties of the diagnosis, the etiologic considerations, and a better definition and classification of the affection.