Published online Feb 16, 2017. doi: 10.12998/wjcc.v5.i2.67
Peer-review started: March 22, 2016
First decision: July 20, 2016
Revised: November 14, 2016
Accepted: December 13, 2016
Article in press: December 14, 2016
Published online: February 16, 2017
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic small- and medium-sized-vessel vasculitis. The literature contains only a few reports of gastrointestinal perforation with this condition. We report a patient with EPGA treated with high-dose steroid who underwent emergency surgery for intestinal perforations. We performed a simple repair of the 11 perforations. Intestinal fistulas developed 8 d postoperatively; they healed well after 60 d of continuous washing and negative pressure suction. The clinical data of 14 additional patients with EGPA or Churg-Strauss syndrome complicated with gastrointestinal perforation, which were reported from 1996 to 2014, were also collected and compared. The formation of multiple perforations and fistulas following high dosage steroid administration can have a good outcome with appropriate management. Meticulous attention to abdominal symptoms and appropriate interventions can result in timely management. Corticosteroid administration remains a very important perioperative procedure for EPGA.
Core tip: Eosinophilic granulomatosis with polyangiitis (EGPA) complicated with intestinal perforation is very rare. It needs urgent surgical intervention but hormone administration usually covers up the situation and delays the prognosis. We report a 43-year-old male diagnosed with EGPA by biopsy who experienced high-dose hormone administration, 11 intestinal perforations, postoperative intestinal fistula, and eventually recovered. This article aims to share the treatment course and experience.