Intestinal pseudo-obstruction as the initial manifestation of systemic lupus erythematosus

Am J Emerg Med. 2019 Jan;37(1):176.e1-176.e2. doi: 10.1016/j.ajem.2018.09.048. Epub 2018 Sep 30.

Abstract

Small bowel obstruction is common in emergency departments. However, the exact cause of intestinal pseudo-obstruction (IPO) is often misdiagnosed. IPO is considered a severe manifestation of systemic lupus erythematosus (SLE). However, IPO is rare as the initial manifestation of SLE. This paper reports a female patient who presented with IPO as the initial manifestation and was ultimately diagnosed with SLE. The 31-year-old female was definitively diagnosed with SLE after IPO symptoms for 1 month. She then presented multiple organ dysfunction syndrome (MODS) leading to a poor prognosis. Patients with unexplained SBO symptoms should be aware of systemic diseases. Early diagnosis and prompt medical treatment are crucial to avoid unnecessary surgery and obtain satisfactory outcomes.

Keywords: Diagnosis; Intestinal pseudo-obstruction; Small bowel obstruction; Systemic lupus erythematosus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cilastatin, Imipenem Drug Combination / therapeutic use
  • Delayed Diagnosis
  • Emergency Service, Hospital
  • Female
  • Humans
  • Immunoglobulins / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Intestinal Pseudo-Obstruction / diagnostic imaging*
  • Intestinal Pseudo-Obstruction / drug therapy
  • Intestinal Pseudo-Obstruction / etiology*
  • Intestine, Small / diagnostic imaging*
  • Lupus Erythematosus, Systemic / complications*
  • Methylprednisolone / therapeutic use
  • Multiple Organ Failure / complications
  • Prognosis
  • Radiography, Abdominal
  • Tomography, X-Ray Computed

Substances

  • Immunoglobulins
  • Immunosuppressive Agents
  • Cilastatin, Imipenem Drug Combination
  • Methylprednisolone