Wegener’s granulomatosis (WG) is a rare form of multisystemic vasculitis. WG most commonly presents as signs and symptoms of upper or lower respiratory tract disease, or both.¹ Although clinical manifestations from the gastrointestinal disease have been described,^2–9 presentation with extensive intestinal ischaemic perforation without renal or pulmonary disease has not been reported. We report a case of WG presenting with extensive small and large bowel ischaemic perforation without renal or pulmonary disease.

A previously healthy 44 year old female was referred for bronchoscopy with an eight week history of lethargy, polyarthralgia, vasculitic skin rash, and distal sensory and motor polyneuropathy. Laboratory analysis showed normal results on full blood count and urinalysis but an elevated erythrocyte sedimentation rate (79 mm/h; normal <15 mm/h) and positive cytoplasmic antineutrophil cytoplasm antibody (c-ANCA; titre 1: …