Abstract
Intestinal involvement is frequent in connective tissue disorders and vasculitides. Among the connective tissue diseases, intestinal involvement is particularly prevalent in systemic sclerosis (SSc). SSc is characterized by intestinal pseudo-obstruction, which may be complicated by small intestinal bacterial overgrowth (SIBO) syndrome and malabsorption. These intestinal syndromes are potentially severe, as they can lead to severe malnutrition and cachexia. Treatment is often difficult; it might require subcutaneous octreotide injections and must associate the treatment of SIBO, based on cycled antibiotics. Intestinal involvement is often regarded as a severe complication of vasculitides. Some clinical manifestations are common to all vasculitides, including ischemia, bowel infarction and perforations, as well as hemorrhage due to mucosal ulcerations or aneurismal ruptures. Some manifestations are more specific and are detailed in this review. Clinical manifestations are often nonspecific and digestive explorations usually have no prognostic value. Treatment of these patients is based on potent immunosuppressive agents, and sometimes requires prompt surgery in case of surgical abdomen.
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