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Rare disease
Case report
Spontaneous bowel perforation in the setting of colonic involvement with scleroderma
  1. Weronika Stupalkowska1,
  2. Betania Mahler-Araujo2,
  3. John Bennett3 and
  4. Stavros Gourgiotis3
  1. 1General Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
  2. 2Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
  3. 3Cambridge Oesophago-Gastric Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
  1. Correspondence to Weronika Stupalkowska; weronika.stupalkowska{at}gmail.com

Abstract

Here we present a rare case of spontaneous colonic perforation in a middle-aged woman affected by systemic sclerosis (SSc). In spite of maximal medical support and prompt emergency laparotomy for source control the patient died due to multiorgan failure within 48 hours of admission. This case emphasises that although rarely, patients with scleroderma can present with colonic perforation which unfortunately due to their decreased physiological reserve, can lead to rapid and irreversible deterioration and subsequent death. It is therefore essential that clinicians faced with abdominal symptoms and signs in patients affected by SSc are able to quickly differentiate acute visceral perforation from benign causes.

  • connective tissue disease
  • general surgery
  • pathology
  • emergency medicine

https://doi.org/10.1136/bcr-2019-233220

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    Footnotes

    • Contributors WS is responsible for writing the manuscript. BM-A edited and provided the images which comprise figure 1 in the article. JB and SG are responsible for planning and conduct of work as well as supervisory role for WS. WS and SG obtained consent from the patient’s next of kin.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.