Surgical and/or conservative therapy in 14 patients with gastrointestinal (GI) disease associated with GPA or MPA.
| Patient No. | GI Event Leading to Emergency Intervention | Type of Intervention | Outcome |
|---|---|---|---|
| 1 | Rectal bleeding, anemia | 9 blood/4 weeks | Died 13 yrs later (renal failure) |
| 2 | 1. Lower left abdom. pain, radiograph: free air. 2. Two weeks later, increasing SIRS, sigmoid perforation | 1. Laparotomy: sigmoiditis + localized purulent peritonitis, perforation not found. Ileostomy: drainage, no resection, abdomen closed. 2. Re-laparotomy: sigmoid perfor. but no diverticula. Hartmann sigmoid resection + colostomy, bowel rest, antibiotics, assisted ventilation, hemodialysis. | Died 30 days later (multiorgan failure) |
| 3 | Lower left abdom. pain, peritonitis | Laparotomy: perforated sigmoid diverticulitis. Hartmann sigmoid resection + colostomy | Died 24 days later (multiorgan failure) |
| 4 | 1. Abdominal pain, peritonitis. 2. Abdominal pain | Laparotomy: Two perforations in ascending colon. Right hemicolectomy + ileocolic resection, primary anastomosis | Healthy 2016 |
| 5 | Lower right abdom. pain | Bowel rest, antibiotics, no blood transfusion | Healthy 2016 |
| 6 | Abdom. pain; CT: hematoma | Arterial coiling, bowel rest, assisted ventilation, blood (no./1 day unknown) | Healthy 2016 |
| 7 | 1. Abdom. pain, peritonitis. 2. Distended bowels, fever | 1. Laparotomy: multiple small bowel perforations. Small bowel resection, prim. anastomosis, delayed closure of abdomen, bowel rest, antibiotics, assist. ventilation. 2. Re-laparotomy: no perforation, diffuse peritonitis, abdomen closed. | Healthy 2016 |
| 8 | Rectal bleeding | Right hemicolectomy, ileostomy, delayed abdom. closure, bowel rest, 12 blood/8 d | Died 10 mos later (heart infarction) |
| 9 | Abdom. pain, CT: free air | Laparotomy: several ileocecal ulcers + perforations. Right hemicolectomia + dual-barrel ileo-/colostomy (not temporary), antibiotics, omeprazole, bowel rest. | Healthy 2016 |
| 10 | Abdom. pain, CT: partial small bowel obstruction | Bowel rest | Died 5 yrs later (malignancy) |
| 11 | Low abdom. pain, CT: abdom. abscess | US-guided drainage of sigmoid abscess, antibiotics, bowel rest | Healthy 2016 |
| 12 | Rectal bleeding, abdom. pain | Antibiotics, omeprazole, nasogastric draining, bowel rest, 12 blood/7 weeks | Healthy 2016 |
| 13 | Rectal bleeding | 7 blood/8 weeks, omeprazole, bowel rest | Healthy 2016 |
| 14 | Rectal bleeding, abdom. pain | 2 blood/2 days, antibiotics, omeprazole, nasogastric draining, bowel rest | Healthy 2016 |
Time to death relates to months or years after start of GI symptoms. Blood refers to units of blood transfusion. US: ultrasound; GPA: granulomatosis with polyangiitis; MPA: microscopic polyangiitis; CT: computed tomography, SIRS: systemic inflammatory response syndrome.