Recurrent small bowel obstruction revealing limited systemic sclerosis. Long-term efficacy of octreotide and erythromycin

Skin abnormalities are the most common manifestations in patients with syst emic sclerosis but many other organs can be involved. We report here the ca se of a 61 year-old-man in whom small bowel involvement was the initial pre sentation of limited systemic sclerosis. The clinical features consisted of recurrent small bowel obstruction without any organic lesion. The patient responded well to erythromycin (125 mg thrice a day before meals) and octre otide (50 mu g subcutaneously at bedtime) with complete symptom relief This permitted recovery of nutritional autonomy for two years. This observation shows that, in patients with intestinal pseudo-obstruction, systemic scler osis should be considered. The long-term administration of octreotide and e rythromycin can be effective in treating small bowel dysmotility in such pa tients.