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(Radiology. 1999;211:203-209.)
© RSNA, 1999

Gastrointestinal Imaging

CT Features of Systemic Lupus Erythematosus in Patients with Acute Abdominal Pain: Emphasis on Ischemic Bowel Disease1

Jae Young Byun, MD, Hyun Kwon Ha, MD, Sue Yun Yu, MD, Jun Ki Min, MD, Sung Hwan Park, MD, Ho Youn Kim, MD, Kyung Ah Chun, MD, Kyu Ho Choi, MD, Byung Hee Ko, MD and Kyung Sub Shinn, MD

1 From the Departments of Radiology ( J.Y.B., S.Y.Y., K.A.C., K.H.C., K.S.S.) and Internal Medicine (J.K.M., S.H.P., H.Y.K.), Kangnam St Mary's Hospital, College of Medicine, the Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul 137-040, Korea; the Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (H.K.H.); and the Department of Diagnostic Radiology, Hanyang University Hospital, Seoul, Korea (B.H.K.). Received December 31, 1997; revision requested February 24, 1998; revision received July 7; accepted October 20. Address reprint requests to J.Y.B.

PURPOSE: To evaluate the computed tomographic (CT) features of systemic lupus erythematosus (SLE) in patients with acute abdominal pain. Special emphasis was placed on the analysis of ischemic bowel disease.

MATERIALS AND METHODS: The authors retrospectively reviewed the images from 39 abdominal CT examinations performed in 33 patients with SLE and acute abdominal pain. Images were evaluated for bowel wall changes, mesenteric changes, fluid collection, retroperitoneal lymphadenopathy, peritoneal enhancement, and hepatomegaly as well as for changes in other abdominal organs. Ischemic bowel disease was diagnosed if at least three of the following signs were seen: bowel wall thickening, target sign, dilatation of intestinal segments, engorgement of mesenteric vessels, and increased attenuation of mesenteric fat.

RESULTS: Thirty-one (79%) of the 39 examinations had CT findings diagnostic of ischemic bowel disease, including symmetric bowel wall thickening (n = 29), target sign (n = 26), and mesenteric vascular engorgement and haziness (n = 31). In 24 cases, bowel wall thickening was multifocal, with variable length, and did not appear to be confined to a single vascular territory.

CONCLUSION: The most common CT finding in patients with SLE and acute abdominal pain is ischemic bowel disease. CT is useful for detecting the primary cause of gastrointestinal symptoms, planning treatment, and monitoring for infarction or perforation.

Index terms: Abdomen, CT, 70.12112, 70.12115 • Intestines, CT, 70.12112, 70.12115 • Intestines, infarction, 70.795 • Intestines, ischemia, 70.799, 70.612 • Lupus erythematosus, 70.612




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