A Case of Systemic Lupus Erythematosus with Perforation of the Rectum

A 45-year-old man, who had been diagnosed as systemic lupus erythematosus (SLE), was admitted for high fever, vomiting and abdominal pain without remarkable development of disease activity of SLE. As intestinal perforation and pan-peritonitis was suspected with intraperitoneal free-air on abdominal CT scan, an emer-gency operation was perfomed. Laparotomy disclosed the perforation of the rectum, and recto-sigmoidectomy and colostomy (Hartmann's procedure) were carried out. Histological examination of the resected specimen showed the necrotizing ischemic colitis. He recoverd by intensive therapy including blood purification. Al-though intestinal perforation in SLE is a rare complication and only 23 patients have been reported to date in Japanese literature, mortality rate is high (39%). When a case of SLE with the abdominal complaints is en-countered, we should pay attention to the life-threatening complication such as intestinal perforation.