Ischemic Bowel Mimicking a Colonic Mass in RS3PE Syndrome

Remitting seronegative symmetrical synovitis with pitting edema syndrome is characterized by symmetrical synovitis involving wrists and flexor digitorum tendon sheaths associated with marked pitting edema of the dorsum of hands. It is considered a paraneoplastic syndrome. Here we describe a middle-aged patient with this syndrome presenting with acute abdomen and ischemic bowel mimicking a colonic mass. Rheumatologists and surgeons should consider mesenteric vascular events in patients with remitting seronegative symmetrical synovitis with pitting edema who present with acute abdomen, even in patients younger than 50 years. Our case is the first case in the literature reporting the association between ischemic infarction of colon and remitting seronegative symmetrical synovitis with pitting edema. Remitting seronegative symmetrical synovitis with pitting edema needs to be listed among other rheumatologic diseases associated with mesenteric vascular occlusion.