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MODERN RHEUMATOLOGY Vol.15 No.5

Vol.15 No.5 に戻る

CASE REPORT

A case of systemic sclerosis sine scleroderma associated with perforation of an afferent loop after subtotal gastrectomy with Billroth 2 anastomosis for its severe gastrointestinal involvement

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Hiroshi Oiwa1, 2 , Yoshihiro Ikemoto1, Koichi Mandai1, Kei Koide1, Toshio Nishida1 and Yasuji Tabe1

(1) Department of Respiratory Medicine, Higashi-hiroshima Medical Center, 513 Jike, Saijo, Higashi-hiroshima, Hiroshima 739-0041, Japan
(2) Present address: Department of Rheumatology, Hiroshima City Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima 730-8518, Japan

Received: 31 March 2005 Accepted: 12 July 2005

Abstract A 50-year-old man was admitted to hospital for dysphagia. The upper gastrointestinal series revealed esophageal stricture, pyloric stenosis, and hypomotile small intestine. He was diagnosed with systemic sclerosis sine scleroderma with gastrointestinal involvement. After subtotal gastrectomy with Billroth 2 anastomosis, he had recurrent intestinal pseudo-obstruction and perforation of the afferent loop. Our experience indicates that surgical procedures in bowel scleroderma, in which an afferent loop is reconstructed, could easily cause perforation of the afferent loop.

Key words Afferent loop - Esophageal stricture - Perforation - Pyloric stenosis - Systemic sclerosis sine scleroderma (ssSSc)

 

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