A Case of Dermatomyositis Associated with Perforation of the Cecum.

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Dermatomyositis is associated with a variety of intestinal complications but intestinal perforation is rare. A case of dermatomyositis associated with perforation of the cecum was reported. A 45-year-old man developed subcutaneus nodules on the trunk, generalized muscle pain, edema and erythema of the face and fever in December, 1988. The symptoms became rapidly so worse that he could not keep daily life including gait, turn in bed and eating. He was referred and admitted to our institution. Laboratory data revealed a marked increase of serum CPK (17520 IU/l) and electromyogram was myogenic. The diagnosis of severe dermatomyositis was made. He was treated with steroid hormone therapy including pulse therapy. On the 20th day of admission he suddenly developed right lower abdominal pain. Plain films of the chest and the abdomen demonstrated subphrenic free airs and the diagnosis of perforation of the gastrointestinal tract was made. Laparotomy revealed perforation of the cecum and cecostomy was performed. Postoperative course was uneventful by prednisolone and ciclosporin. Ileo-cecectomy and ileocolostomy were secondarily performed. He became to walk independently and to manage daily life and was discharged in May, 1990.
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