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CASE REPORT
Lupus causing small bowel obstruction
  1. Yunfei Yang1,
  2. Anne-Marie Bartsch1,
  3. Eve Fryer2,
  4. Daniel Hancu3
  1. 1Oxford University Medical School, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
  2. 2Department of Pathology, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
  3. 3Department of Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
  1. Correspondence to Yunfei Yang, yunfei.yang{at}gtc.ox.ac.uk

Summary

A 20-year-old female patient was admitted to hospital in 2015 with 1 year history of recurrent abdominal pain, distension, borborygmi and nausea. The patient had a background of systemic lupus erythematous (SLE) diagnosed 4 years before, with skin, joint and renal involvement. The initial investigations have shown a long segment of ileal inflammation with upstream obstruction. Differential diagnoses were mainly SLE enteritis or concomitant Crohn’s. Patient failed the initial conservative management and had a laparotomy with small bowel (SB) resection and ileostomy. The histology was suggestive of autoimmune enteritis. Although bowel involvement is a frequent feature of SLE, surgery for obstruction is extremely rare. Postoperatively, she had an emergency admission and was diagnosed with SB volvulus with perforation. She underwent further resection and stoma refashioning in 2016. As a consequence, she developed short gut syndrome. Eventually, the stoma was reversed and parenteral nutrition was stopped and weight became stable.

  • small intestine
  • malabsorption
  • nephrotic syndrome
  • systemic lupus erythematosus
  • surgery
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Footnotes

  • Contributors YY acquired data, analysed, assisted with design and drafted the work. A-MB assisted in acquiring the data. EF acquired and advised with histopathology, DH designed, acquired data, analysed and drafted the work. All authors approved the final version.

  • 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 Obtained.

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

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