Lupus abdominal crisis owing to rupture of an ileocolic aneurysm with successful angiographic treatment.
There are many causes of acute abdominal pain, or abdominal "crises," in patients with systemic lupus erythematosus (SLE), most frequently the causes are serositis or vasculitis. Vasculitis generally causes small vessel abnormalities and may present with symptoms owing to mucosal damage, such as pain, diarrhea, or bleeding. We present a patient with SLE who had the acute onset of severe abdominal pain while hospitalized for a lupus flare and who was found to have a ruptured ileocolic aneurysm with intraperitoneal bleeding. She was successfully managed with angiographic embolization, without further complications. Although angiography is well established as a therapeutic intervention for mesenteric aneurysms of various etiologies, this is the first case of an SLE-related ileocolic aneurysm so managed. This entity should be considered in the differential diagnosis of abdominal pain in patients with lupus, and angiographic embolization should be considered in its management.
Division of Gastroenterology University of Miami School of Medicine Miami, Florida, USA.
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Stollman
D000006:Abdomen, Acute / Q000209:etiology; D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D000792:Angiography; D003106:Colon / Q000098:blood supply*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007082:Ileum / Q000098:blood supply*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*