LAUSR

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multiple systems and organs involved, causing various clinical manifestations. Lupus mesenteric vasculitis (LMV) is the main feature of digestive tract involvement in SLE, which manifests different symptoms such as abdominal pain, diarrhoea, nausea, vomiting and intestinal bleeding. Although the complications can occur in any part of the gastrointestinal tract, the most common position involved is small intestine, while colon lesions are rare. It is easy to be ignored in clinical practice because abdominal symptoms are usually mild and lack of specificity. A 51-year-old woman presented to the department of colorectal surgery with a long history of chronic abdominal pain. She had a history of SLE for 30 years and right hemi-colectomy due to ascending colon perforation 5 years before. On physical examination, the lower left abdomen was found to be tender, and the patient complained of a defaecation disorder. Findings on computed tomography of the abdomen and pelvis revealed atherosclerosis of aorta, high-density calcification shadow of mesosigmoid and mesorectum, and stenosis of sigmoid colon (Fig. 1). At colonoscopy the instrument could not pass the narrow sigmoid even though the mucosa was smooth. Barium enema indicated narrowing of the distal sigmoid colon. The patient underwent surgery of segmental colorectum and mesentery resection. Where it was found that the sigmoid colon and the rectal mesentery were extensively calcific and lumpy, and the intestinal tube was twisted by contracture of the mesentery resulting in partial obstruction. Histopathological examination confirmed the presence of mesenteric vascular inflammatory change, accompanied by a large lymphocyte infiltration, vascular wall hyaline degeneration associated with calcification (Fig. 2), intestinal wall serosal surface connective tissue hyperplasia with extensive calcification (Fig. 3).