Case Report
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World J Gastrointest Surg. May 27, 2010; 2(5): 169-171
Published online May 27, 2010. doi: 10.4240/wjgs.v2.i5.169
Intestinal perforation as an early complication in Wegener’s granulomatosis
Morsal Samim, Apollo Pronk, Paulus Menno Verheijen
Morsal Samim, Apollo Pronk, Paulus Menno Verheijen, Department of Surgery, Diakonessenhuis, Bosboomstraat 1, 3582 KE, Utrecht, The Netherlands
Author contributions: Verheijen PM drafted, wrote and revised the manuscript; Pronk A drafted and revised the manuscript; Samim M drafted and wrote the manuscript.
Correspondence to: Dr. Morsal Samim, Department of Surgery, Diakonessenhuis, Bosboomstraat 1, 3582 KE, Utrecht, The Netherlands. m.samim1@students.uu.nl
Telephone: +31-64-4250665 Fax: +31-30-2566210
Received: November 10, 2009
Revised: December 19, 2009
Accepted: December 26, 2009
Published online: May 27, 2010
Abstract

We present the case of a young man with involvement of the gastrointestinal tract in the early phase of Wegener’s granulomatosis. The patient presented at the emergency department with sudden onset of abdominal pain, nausea and vomiting. Radiography work up was negative for free air although ultrasound examination showed extraluminal intra-abdominal fluid. Exploratory laparotomy showed perforation of the jejunum. The bowel was vital except for this small segment of jejunum. A 5-cm long segment of jejunum was resected which revealed ulcerative inflammation accompanied by occluded arteries of the small intestine. Although intestinal perforation in Wegener’s granulomatosis is uncommon, several cases have been previously reported. Intestinal involvement in the early phase of the disease is even more uncommon. This case combined with previously reported cases emphasizes the possibility of gastrointestinal manifestation early in Wegener’s disease.

Keywords: Wegener’s granulomatosis; Intestinal tract; Perforation