Multiple intestinal perforation in a patient with Wegener's granulomatosis: A case report and review of the literature (original) (raw)

Intestinal perforation in Wegener's granulomatosis: a case report

Ulusal Travma Dergisi Turkish Journal of Trauma Emergency Surgery Tjtes, 2005

is a rare systemic necrotizing vasculitis of unknown etiology with distinct clinical and histological features. Classically, the localized forms of Wegener' s granulomatosis involve the upper and/or lower respiratory tracts and kidneys. It might rarely involve any part of the body as well as gastrointestinal tract [1-4]. Gastrointestinal signs and symptoms are uncommon. Intestinal involvement may be severe and numerous cases of perforation and bleeding of gastrointestinal tract have been reported. [5-7] but only a few cases had the histological evidence of vasculitis 348

Nontraumatic hepatic hematoma caused by Wegener's granulomatosis: an unusual cause of abdominal pain

The New Zealand medical journal, 2010

Wegener's granulomatosis (WG) is a vasculitis of unknown origin characterised by prominent involvement of upper and lower respiratory tract and kidney. There are only a handful of reported cases in the literature about hepatic involvement of WG. This report shows a patient with WG whose main complaint was severe abdominal pain due to nontraumatic subcapsular hepatic hematoma. To our knowledge, this is the first reported case of WG with hepatic hematoma depicted by US and CT in the English literature.

Limited form of wegener's granulomatosis in a patient with Crohn's disease. A case report

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2014

Wegener's granulomatosis (WG) is a multisystemic disease of unknown etiology characterized by necrotizing vasculitis and granulomatous inflammation. Although, the gastrointestinal tract can be involved in this vasculitis, the association between WG and Crohn's disease (CD) exists and was previously described. We report the case of a 29 year-old Tunisian white patient previously diagnosed with CD, presenting 3 years later with a perforated nasal septum, mucosal ulcers and sinusitis. He had also a skin ulcerative eruption of the trunk. There was no evidence of a flare of his CD. A computed tomography scan of the head showed nasal septal perforation, and maxillary pansinusitis. A biopsy from the nasal septum demonstrated nasal mucosa with extensive necrotizing granulomatous reaction associated with vasculitis. The patient was diagnosed as having limited form of Wegener's granulomatosis. He was treated with prednisone 60 mg/day and methotrexate 15 mg weekly. After Two months...

About a rare cause of intestinal perforation

Open Journal of Internal Medicine, 2011

Background: Periarteritis nodosa (PAN) is a necrotizing systemic vasculitis involving medium-sized arteries and rarely the small-sized ones. It affects various organs and is generally revealed by different non specific organs. The aim of the authors is to report a rare revealing manifestation of this disease which is the perforation of the small bowel and to highlight the most important histological features. Case report: The authors describe the case of a 48-year-old Caucasian woman, without a particular past medical history, who presented an acute surgical abdomen. A surgical exploration was decided and showed a necrosis of the small bowel and the appendix. A segmental ileectomy was performed. The histological examination of the specimen showed small vasculitis-affected with fibroid necrosis dealing to the diagnosis of intestinal perforation caused by a PAN was retained. Post-operatively, the patient was put on immunosuppressive therapy and presented a prolonged healing process and was discharged from the hospital 20 days after her admission. Conclusion: Although it is rare for PAN to be revealed by small bowel perforation, it should be kept in mind when facing ischemic change of the small bowel.

Periaortitis and Aortic Dissection due to Wegener's Granulomatosis

Clinical Rheumatology, 2000

We describe here a patient with abdominal periaortitis and intramural dissection as early manifestations of Wegener's granulomatosis (WG). Surgical biopsies taken from the retroperitoneal inflammatory tissue surrounding the aorta showed granulomatous vasculitis. The patient had antiproteinase-3 antibodies and suffered from nasal, pulmonary, nervous and renal WG involvement. Although being a vasculitis of medium size and small vessels, WG should be included in the systemic vasculitides which can give rise to (peri)aortic inflammation.

Ruptured arterial aneurysm in Wegener’s granulomatosis: a case report

Journal of Medical Case Reports, 2021

Background Aneurysm formation is a possible, but rare, complication of granulomatosis with polyangiitis, known as Wegener’s granulomatosis. Urgent diagnosis and therapy is very important because a ruptured aneurysm could be life threatening. Case presentation We, therefore, present the case of a 63-year-old Greek man who was diagnosed with granulomatosis with polyangiitis and retroperitoneal hematoma due to ruptured aneurysm in renal artery and upper pancreaticoduodenal artery. His clinical course was complicated by acute renal failure and acute respiratory failure due to alveolar hemorrhage. Emergency coil embolization was performed. Postembolization recovery was uneventful; no bleeding occurred. The patient underwent mechanical ventilation and continuous veno-venous hemofiltration and received combined immunosuppression and supportive therapy, but eventually died 30 days after admission to hospital from severe septic shock and multiple organ failure. Conclusion Endovascular treatm...

An unusual presentation of relapsing Wegener's granulomatosis

Nephrology Dialysis Transplantation, 2001

Wegener's granulomatosis (WG) has not been included in the differential diagnosis for ulcerative colitis or Crohn's disease. However, affection of the gut has been detected at autopsy in a signi®cant number of patients w1x even in the absence of a WG relapse. We present a case in whom ileitis was the initial presentation of WG disease relapse. Case. The patient was a 36-year old man who presented in October 1991 with fatigue, weight loss, sinusitis, acute renal failure, and pulmonary in®ltrates. Kidney biopsy revealed pauci-immune crescentic glomerulonephritis without necrotizing lesions or interstitial abnormalities. cANCA were positive (titre 250). WG was diagnosed and cyclophosphamide and corticosteroids administered for 18 months.