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Intestinal perforation. A common complication of scleroderma
E C Ebert1, F M Ruggiero, J R Seibold
1Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA.
Digestive Diseases and Sciences
|March 1, 1997
Summary
Systemic sclerosis (SSc) patients have significantly higher rates of intestinal perforation due to inherent wall weakness. This finding is crucial for gastroenterologists performing procedures on SSc patients.
Area of Science:
- Gastroenterology
- Pathology
- Rheumatology
Background:
- Intestinal complications in systemic sclerosis (SSc) are primarily linked to motor dysfunction.
- Anatomical abnormalities contributing to these complications require investigation.
Purpose of the Study:
- To identify anatomical abnormalities in the intestines of systemic sclerosis patients.
- To compare intestinal autopsy findings in SSc patients with a related disease control group.
Main Methods:
- Autopsy descriptions of intestinal organs were compared between 16 SSc patients and 18 systemic lupus erythematosus (SLE) patients.
- Incidence of intestinal perforation was statistically analyzed between the two groups.
Main Results:
- Systemic sclerosis patients exhibited a significantly higher incidence of intestinal perforation (7/16) compared to SLE patients (1/18).
- Perforations in SSc involved various bowel segments, including esophagus, duodenum, ileum, and colon, with some being silent.
- The single perforation in SLE was attributed to vasculitis-induced necrosis.
Conclusions:
- The intestinal walls of patients with systemic sclerosis appear to possess inherent weakness.
- Gastroenterologists should exercise caution and consider this inherent weakness during invasive procedures in SSc patients.