About a rare cause of intestinal perforation

Background: Periarteritis nodosa (PAN) is a necrotizing systemic vasculitis involving mediumsized arteries and rarely the smallsized ones. It affects various organs and is generally revealed by different non specific organs. The aim of the authors is to report a rare revealing manifestation of this disease which is the perforation of the small bowel and to highlight the most important histological features. Case report: The authors describe the case of a 48-year-old Caucasian woman, without a particular past medical history, who presented an acute surgical abdomen. A surgical exploration was decided and showed a necrosis of the small bowel and the appendix. A segmental ileectomy was performed. The histological examination of the specimen showed small vasculitis-affected with fibroid necrosis dealing to the diagnosis of intestinal perforation caused by a PAN was retained. Post-operatively, the patient was put on immunosuppressive therapy and presented a prolonged healing process and was discharged from the hospital 20 days after her admission. Conclusion: Although it is rare for PAN to be revealed by small bowel perforation, it should be kept in mind when facing ischemic change of the small bowel.