A Case Report of the Perforation of Descending Colon Undergoing Treatment for Wegener's Granulomatosis

A 71-year-old man who had been given a diagnosis of C-ANCA associated artiritis at a nearby hospital was admitted to our hospital. Based on pathological findings of kidney and skin biopsies, a diagnosis of Wegener's granulomatosis (WG) was given. He was successfully treated with steroid pulse therapy and cyclophosphamide pulse therapy. On the 32nd day, he suddenly began to suffer from severe abdominal pain. We conducted abdominal CT, which showed free air in the abdominal cavity, necessitating emergency surgery. The descending colon had been perforated, so we resected the perforated region with a stoma of oral colon. During the postoperative course, there was recurrence of WG which was difficult to control, however, we were able to save the patient's life. Although the prognosis of WG has improved, cases of intestinal perforation with WG are still rare and have bad prognosis. We must be aware of gastrointestinal lesions of WG, and in case of perforation, an emergency operation with postoperative intensive care are essential.