Ischemic duodenal injury due to systemic lupus erythematosus: A case report

Figure 1  Facial urticarial lesions and purpura on both lower legs at presentation.

Figure 2 The patient's imaging results. A: Preoperative contrast-enhanced computed tomography (CT; transverse view) shows duodenal wall thickening and mesenteric congestion; B: Coronal CT view demonstrates venous engorgement and submucosal edema extending from the duodenum to the jejunum; C: Contrast-enhanced abdominal CT at 8 months postoperatively shows an intact anastomosis and no abnormal biliary dilation.

Figure 3 Surgical illustration. A: Schematic illustration of the intraoperative findings, showing an edematous duodenum with prominent venous congestion; B: Illustration of the duodenojejunostomy after segmental resection.

Figure 4  Gross specimen shows transmural edema and hemorrhagic-appearing mucosa without perforation.

Figure 5 Postoperative laboratory trends show transient hyperbilirubinemia and subsequent normalization after stent placement. POD: Postoperative day; MRCP: Magnetic resonance cholangiopancreatography; PTGBD: Percutaneous transhepatic gallbladder drainage; PTBD: Percutaneous transhepatic biliary drainage; Bil: Bilirubin; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase.