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Erschienen in:
25.09.2022 | Image of the Month
Interstitial Lung Disease, Intestinal Pseudo-obstruction, Biliary Tract Dilatation in a Patient with Sjogren’s Syndrome
Erschienen in: Digestive Diseases and Sciences | Ausgabe 1/2023
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A female patient was diagnosed with Sjogren’s syndrome (SS) [1], presenting with respiratory failure and digestive obstruction symptoms. Organizing pneumonia (Fig. 2), dilation of biliary tract, and intestinal pseudo-obstruction accounted for these complaints. Abdominal X-ray showed accumulation of gas and feces in the intestine (Fig. 1A). High-resolution computed tomography (CT) scan showed dilated biliary tract (Fig. 2), which was confirmed by magnetic resonance cholangiopancreatography (Fig. 1B). The oxygenation index improved gradually, and digestive symptoms slightly relieved after immunosuppressive treatment with glucocorticoid and cyclophosphamide (Fig. 2). This is the first report of a patient with SS complicated by organizing pneumonia, pseudo-intestinal obstruction, and biliary tract dilatation, simultaneously [2, 3].
Fig. 1
Imaging of intestinal pseudo-obstruction and biliary tract dilatation. A Abdominal plain film showing gastric filling (dark arrow), intestinal gas, and fecal accumulation (dark arrow) on 30 June and 11 November 2021, respectively; B dilated biliary tract (white arrow) on abdominal CT scan, abdominal magnetic resonance imaging, and magnetic resonance cholangiopancreatography
Fig. 2
Serial computed tomography scan of the patient. A Ground-glass opacity and infiltrates distributed on bilateral lungs on 2 July 2021 (dark arrow); B removable infiltrates distributed on bilateral lungs on 13 July 2021 (dark arrow showing removable shadow on CT); C high assimilation of ground-glass opacity and infiltrates after 1-month glucocorticoid therapy on 20 August 2021. A–C show a dilated stomach and biliary tract (white arrow) with delayed gastric emptying over time
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