The patient who has developed a life endangering gastrointestinal complication associated with a collagen disease challenges the surgeon with problems of early recognition of the complication in patients who frequently experience abdominal pain as part of their systemic disease, execution of that emergency treatment and operation most likely to preserve life, and careful postoperative management for patients who have a limited healing capacity. In some instances the diagnosis of the collagen disease may not have been established prior to the occurrence of the gastrointestinal complication.
Gastrointestinal complications occurring in collagen diseases have appeared in the recent literature with increasing frequency. Intestinal infarction, perforation, and hemorrhage have been reported occurring in periarteritis nodosa, or the vasculitis group,1-8 but also in systemic lupus erythematosus and dermatomyositis.9-11 A common pathogenic process is very possible.12-15 While the importance of steroid therapy is still unsettled, its inability to protect and prevent gastrointestinal