Arteritis and Infarction of the Intestine in Rheumatoid Arthritis

Two patients with rheumatoid arthritis developed an acute fulminating form of mesenteric arteritis and intestinal necrosis that required surgical resection. Only one had been receiving adrenal corticosteroid treatment. Both were operated upon twice and have been maintained on anticoagulant and steroid treatment. Neither patient has had any recurrence of abdominal symptoms. Immediate treatment with anticoagulants after surgery appeared to be beneficial. An awareness of the occurrence of necrotizing mesenteric arteritis in patients with rheumatoid arthritis who develop signs of an acute condition within the abdomen is essential if a fatality from unsuspected bowel gangrene is to be avoided. The nature of the acute arteritis and its relationship to adrenal corticosteroid treatment, rheumatoid arthritis, and connective tissue disease are discussed.