There are many causes of acute abdominal pain, or abdominal “crises,” in patients with systemic lupus erythematosus (SLE), most frequently the causes are serositis or vasculitis. Vasculitis generally causes small vessel abnormalities and may present with symptoms owing to mucosal damage, such as pain, diarrhea, or bleeding. We present a patient with SLE who had the acute onset of severe abdominal pain while hospitalized for a lupus flare and who was found to have a ruptured ileocolic aneurysm with intraperitoneal bleeding. She was successfully managed with angiographic embolization, without further complications. Although angiography is well established as a therapeutic intervention for mesenteric aneurysms of various etiologies, this is the first case of an SLE-related ileocolic aneurysm so managed. This entity should be considered in the differential diagnosis of abdominal pain in patients with lupus, and angiographic embolization should be considered in its management.
From the Division of Gastroenterology University of Miami School of Medicine Miami, Florida, U.S.A.
Submitted August 17, 1999.
Accepted December 15, 1999.
Financial support/potential conflict of interest: none.
Address correspondence and reprint requests to Dr. Neil H. Stollman, Division of Gastroenterology, San Francisco General Hospital, Ward 3-D, 1001 Potrero Avenue, San Francisco, CA 94110, U.S.A. E-mail: Nstollman@medsfgh.ucsf.edu