Diffuse ischemic colitis associated with systemic lupus erythematosus--response to subtotal colectomy.

A 26-year-old woman with systemic lupus erythematosus developed massive rectal bleeding that failed to respond to medical treatment. X-rays and proctoscopy indicated that she had universal colitis. She underwent emergency subtotal colectomy because of a rapidly declining clinical course. The small intestine appeared normal. Pathological examination demonstrated a gangrenous large intestine, ischemic ulcerations, and extensive fibrinoid vasculitis that was typical of systemic lupus. The patient has had no further gastrointestinal complaints for 2 years since surgery.