Delay in diagnosis of intestinal obstruction in a 17 year-old female with Familial Mediterranean fever: The first case report from Syria

Familial Mediterranean fever (FMF) is an autosomal recessive auto-inflammatory disorder characterized mainly by brief recurrent episodes of peritonitis, pleuritis, and arthritis, usually with accompanying fever. Almost all patients with FMF experience abdominal episodes. Abdominal pain develops, and may progress to peritonitis. Intestinal obstruction secondary to adhesions may be observed in FMF patients but this is the first case from Syria. A 17-year-old Syrian female patient presented to our hospital complaining of abdominal pain, frequent vomiting, weight loss and absolute constipation in the past ten days, with a confirmation of her infecting by FMF 3 years ago. The obstruction was treated conservatively and after 6 months we had to treat the obstruction by laparoscopic releasing of abdominal bands as a result of recurrence. The patient was discharged and followed up for 6 months with excellent results. We herein report the first known case of FMF with small bowel obstruction in Syria with delayed in diagnosis. Physicians should be alert to this possible complication when FMF patients arrive at the emergency room.