Mousavie Seyed Hamzeh, Mirzaei Rezvan, Mahjoubi Bahar, Azizi Rasoul
Department of General Surgery, Division of Colon and Rectal Surgery, Hazrat-e-Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran.
Associated Professor of Colorectal Surgery, Division of Colon and Rectal Surgery, Hazrat-e-Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran.
J Res Med Sci. 2014 Mar;19(3):276-8.
Classic Polyarteritis nodosa (PAN)) is a medium-sized vessel vasculitis that usually occurs in middle-aged men. One of the dramatic manifestations of PAN that requires surgical intervention is multiple small bowel perforations. Many studies have reported a high rate of mortality in PAN due to acute abdominal complications. We report here the case of multiple small bowel perforations in a 22-year-old man, who presented with an acute abdomen, and eventually, PAN was diagnosed. In our case, PAN led to multiple small bowel perforations and diffuse patchy necrosis. All perforations were primarily repaired and corticosteroids were prescribed. Using corticosteroid in patients with abdominal sepsis is injurious; however, laparostomy is the method we suggest, to achieve the purpose, including prevention of a short bowel and infection control. Our patient was discharged, well, after 48 days of hospitalization and referred to a rheumatologist.
经典结节性多动脉炎（PAN）是一种中型血管炎，通常发生于中年男性。PAN需要手术干预的一个显著表现是多处小肠穿孔。许多研究报告称，PAN因急性腹部并发症导致的死亡率很高。我们在此报告一名22岁男性发生多处小肠穿孔的病例，该患者表现为急腹症，最终被诊断为PAN。在我们的病例中，PAN导致多处小肠穿孔和弥漫性片状坏死。所有穿孔均首先进行了修复，并开具了皮质类固醇药物。在腹部脓毒症患者中使用皮质类固醇有害；然而，我们建议采用剖腹造口术来达到目的，包括预防短肠综合征和控制感染。我们的患者在住院48天后康复出院，并转诊至风湿病专家处。
