24 May 2019 : Case report
Recurrent Asymptomatic Sigmoid Diverticular Perforation in a Patient with Pemphigus Vulgaris on Immunosuppressive Therapy: A Case Report
Challenging differential diagnosis, Unusual setting of medical care, Rare coexistence of disease or pathologyChristian Saliba1ABCE, Hussein Rabah2ABCE, Gregory Nicolas1ABDE*, Nancy Emmanuel3CDE, Ahmad Sleiman4CDG, Mohammad Hashem1BCDG, Rola Hussein5CDG, Ali El Masri1CDG, Rim Abboud1CDG, Mohammad Fawaz1CDG, Houssein Haidar Ahmad1ACDF
Am J Case Rep 2019; 20:735-738
BACKGROUND: Perforation of the colon is associated with high mortality and requires early diagnosis. However, the diagnosis of perforation from atypical causes can be a diagnostic challenge. This report is of a rare case of recurrent sigmoid colonic perforation in a patient with diverticular disease who did not present with an acute abdomen but who had pemphigus vulgaris treated with immunosuppressive therapy.
CASE REPORT: A 57-year-old man with pemphigus vulgaris was treated with steroids, non-steroidal anti-inflammatory drugs (NSAIDS), and azathioprine. He had episodes of abdominal bloating but denied any other symptoms. He was diagnosed with spontaneous sigmoid diverticular perforation without presenting with an acute abdomen.
CONCLUSIONS: Diverticular perforation can be asymptomatic in patients on immunosuppressive therapy. Therefore, there should be a high index of suspicion for bowel perforation in patients with abdominal symptoms who are treated for skin diseases, such as pemphigus vulgaris, and are on steroids and other immunosuppressive treatments.
Keywords: diverticulitis, Intestinal Perforation, pemphigus, Anti-Inflammatory Agents, Non-Steroidal, azathioprine, Diverticulum, Colon, Immunosuppressive Agents, Middle Aged, Recurrence, Sigmoid Diseases
28 Sep 2023 : Case reportSurgical Treatment of a Neglected Thumb Volar Plate Injury in an 11-Year-Old Girl: A Case Report
Am J Case Rep In Press; DOI: 10.12659/AJCR.940411
28 Sep 2023 : Case reportIleocolic Intussusception in Infancy is not Always Idiopathic – Adenomyoma as the Leading Point
Am J Case Rep In Press; DOI: 10.12659/AJCR.939789
27 Sep 2023 : Case reportLife-Threatening Cardiac Arrhythmias in a Case of Undetected Myxedema Coma: Importance of Early Detection a...
Am J Case Rep In Press; DOI: 10.12659/AJCR.941414
Most Viewed Current Articles
06 Dec 2021 : Case reportLipedema Can Be Treated Non-Surgically: A Report of 5 Cases
Am J Case Rep 2021; 22:e934406
07 Dec 2021 : Case reportEdwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...
Am J Case Rep 2021; 22:e934347
13 Jul 2022 : Case reportWhistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound
Am J Case Rep 2022; 23:e936441