PERFORATION OF THE TRANSVERSE COLON DUE TO CYTOMEGALOVIRUS ENTERITIS IN A PATIENT WITH WERNER'S SYNDROME

Abstract

A 49-year-old woman with Werner's syndrome was admitted to the hospital because of epigastralgia. Her abdomen was distended with muscular defence. Abdominal CT scan demonstrated the presence of free air. She was diagnosed as having panperitonitis due to perforation of the gastrointestinal (GI) tract, and an emergency operation was performed. At surgery, amounts of stool in the abdominal cavity was found and a perforated region of the transverse colon was recognized. A partial resection of the transverse colon with a colostomy was performed. Microscopic examination showed ulcer formation with infiltration of lots of lymphocytes with acidophilic intranuclear inclusion bodies. On immunohistochemical staining, these inclusion bodies were positive to anti-CMV antibody. There have been no reports of the case with Werner's syndrome and idiopathic colonic perforation due to CMV infection. Opportunitic CMV infection should be included in the defferential diagnosis of perforation of the GI tract of unknown cause in an immuno-compromised host.