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August 1982

Torsion of Appendix Epiploica and Acute Abdominal Pain in Systemic Lupus Erythematosus

Author Affiliations

University of Louisville School of Medicine; Kosair-Children's Hospital Medical Center; Louisville

Am J Dis Child. 1982;136(8):748. doi:10.1001/archpedi.1982.03970440092032

Systemic lupus erythematosus (SLE) is a disease with protean manifestations. The incidence of severe abdominal pain has been reported to be as high as 18%.1 The differential diagnosis for severe abdominal pain in patients with SLE includes appendicitis, pancreatitis, cholecystitis, ulcerative colitis, regional enteritis, diverticulitis, pelvic inflammatory disease, perforated peptic ulcer, lupus polyserositis, and mesenteric arthritis with intestinal ischemia2; cases of adynamic small-bowel obstruction, spontaneous rupture of the liver or spleen, and omental infarct have been cited by Stoddard et al, whose review of the world literature contains 36 cases of patients with SLE whose acute abdominal pain required laparotomy.3 We report an additional case, with a cause that, to our knowledge, has not been reported.

Report of a Case.—The patient is a 15-year-old, Tanner stage II girl in whom the diagnosis of SLE was made at age 11 when she was found to have multisystem