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Mesenteric vasculitis with genitourinary tract involvement in systemic lupus erythematosus
  1. Darshana D Rasalkar,
  2. Bhawan K Paunipagar
  1. Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Republic of China
  1. Correspondence to Darshana Rasalkar, Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Ngan Shing St., Shatin, New Territories, Hong Kong, Republic of China; drdarshanar{at}

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Case history

A middle-aged man with systemic lupus erythematosus (SLE) presented with acute onset of abdominal pain associated with diarrhoea and vomiting. The patient was haemodynamically stable and the hydration was maintained. The patient also had intermittent urgency and a sense of incomplete urinary bladder emptying. Emergency multidetector CT scans of the abdomen and pelvis revealed moderate to severe wall oedema and mucosal swelling of the small bowel (figure 1) and entire length of the large colon (figure 2). There was moderate to severe stranding and increased vascularity within the mesentery and the mesocolon (figures 1 and 2). The major abdominal vessels, including the mesenteric arteries and veins, however, were patent.

Figure 1

Contrast-enhanced axial CT scan of the abdomen showing multiple fluid-filled small bowel loops with thickened walls. Note the target appearance (alternating white and black layers) (white arrows), ascites (black arrowhead) and bilateral dilated ureters (white arrowheads).

Figure 2

Contrast-enhanced axial CT scan of the …

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  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Prince of Wales Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.