title: Multiple ileal perforations in a patient with Wegener's granulomatosis: a case report and literature review.
abstract: BACKGROUND
  Wegener's granulomatosis (WG) is a chronic, multisystemic disease of unknown etiology characterized by necrotizing vasculitis and granulomatous inflammation. WG primarily involves the upper and lower respiratory tract and kidneys, but it may also affect multiple other organs or tissues, including the gastrointestinal system.
  
  
  CONCLUSIONS
  Gastrointestinal involvement is an extremely rare manifestation of this disease. Moreover, during the course of WG, intestinal perforation is extremely rare in patients with gastrointestinal involvement. To our knowledge, only 13 WG cases with intestinal perforation have been reported in the English language literature as of September 2011.
  
  
  BACKGROUND
  We herein present the case of a 47-year-old male patient with WG who was diagnosed with multiple ileal perforations and ileovesical fistulae. The exact pathogenesis of intestinal perforation in WG is not fully understood. However, early surgical intervention and appropriate management with immunosuppressive therapy can be important to lifesaving measures. A review of 13 cases reported in the English language literature is also discussed, together with the pathogenesis of this serious complication.
authors: Department of Surgery, Diyarbakir Education and Research Hospital, 21400, Diyarbakir, Turkey. akbulutsami@gmail.com
authors: Sami
authors: S
authors: Akbulut
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D017809:Fatal Outcome; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology* / Q000601:surgery; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007412:Intestinal Fistula / Q000209:etiology* / Q000601:surgery; D007416:Intestinal Perforation / Q000209:etiology* / Q000601:surgery; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D018805:Sepsis / Q000188:drug therapy / Q000382:microbiology; D013845:Thienamycins / Q000627:therapeutic use; D001747:Urinary Bladder Fistula / Q000209:etiology* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D013845:Thienamycins; D003520:Cyclophosphamide; D011239:Prednisolone; D000077731:Meropenem