Ischaemic necrosis of the rectum and sigmoid colon complicating systemic lupus erythematosus

The case of a 37-year-old Caucasian female with a history of sys- temic lupus erythematosus, admitted to hospital due to progressi- vely worsening abdominal pain and arthralgia. During hospitali- sation, signs of acute abdomen developed. Laparotomy revealed perforation of the rectum, accompanied by necrosis of the recto- sigmoid. Histologic examination revealed vasculitis involving small- and medium-sized vessels. This case report emphasizes the point that colonic and especially rectal involvement from vasculitis, though unusual, may present with profound and possibly life-threatening manifestations and stresses the difficulties in clinical and histological differential diag- nosis from other causes of systemic lupus erythematosus-associa- ted abdominal pain.