Systemic lupus erythematosis with enterocolitis

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

Patient presented with abdominal pain and distension as well as diarrhea. History of systemic lupus erythrematosus

Patient Data

Age: 30
Gender: Female

CT Enterocolonography

Modality: CT

Extensive bowel inflammatory change along the rectum, descending and ascending colon, terminal ileum and one of the proximal ileal loops. The involved segments show circumferential wall thickening averaging 4- 9 mm and increased mucosal enhancement with submucosal edema giving water-halo sign. Engorged mesenteric vessels. There is also a partially-loculated abdominal collection in the pelvis and mesenteric root lymph nodes averaging 7-10 mm.

Patent mesenteric arteries including the SMA and the IMA. Patent portal venous axis including the portal vein and SMV.

Partially collapsed urinary bladder showing diffuse circumferential mural thickening averaging 1 cm suggesting cystitis with consequent bilateral hydro-ureteronephrosis. No stones detected.

Mild gallbladder wall thickening.

Case Discussion

In view of the patient's medical history of systemic lupus erythematosis (SLE) and the appearance of the bowel, lupus enteritis from vasculitis can be considered. Lupus enteritis is a rare manifestation of the disease, but is important to suggest as the vasculitis requires control of the disease by high doses of steroids.

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Case Information

rID: 44564
Case created: 27th Apr 2016
Last edited: 29th Apr 2016
Inclusion in quiz mode: Excluded

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