A case of stenosis of the large intestine due to systemic lupus erythematosus treated by laparoscopic low anterior resection

A 34-year-old man had an 8-year history of systemic lupus erythematosus (SLE) controlled by oral prednisolone. He had abdominal pain and underwent colonoscopy 3 years after the initial diagnosis. Colonoscopy revealed an ulcerative lesion and stenosis in the rectosigmoid colon. He was treated by prednisolone enema, because colonic inflammation associated with SLE was diagnosed. He obtained symptomatic relief for a period, but he developed abdominal distension again after 1 year. The lesions were eventually diagnosed as ulcerative colitis as a complication of SLE. Despite the introduction of oral mesalazine, the stenosis did not show significant improvement and he was referred to our hospital for surgical treatment. Laparoscopic low anterior resection was performed without perioperative complications, after 5 years from the first abdominal pain. Pathological results revealed that the stenosis was a result of thrombosis caused by anti-phospholipid antibody and lupus vasuculitis. Stenosis of the large intestine due to SLE is a very rare entity and only 4 cases have been reported in the literature. To the best of our knowledge, this is the first case report of laparoscopic colectomy for stenosis of the large intestine due to SLE.