Abstract
Systemic sclerosis (SSc) is a rare, chronic systemic rheumatic disease. Gastrointestinal (GI) involvement is highly prevalent in SSc and any part of the GI tract may be affected. This can range from mild symptoms like heartburn and dysphagia to severe issues like abdominal distention, malnutrition, and fecal incontinence. In SSc patients, GI tract dysfunction significantly impacts the quality of life and is a major contributor to both morbidity and mortality. This case report highlights an 80-year-old female patient with SSc/CREST (Calcinosis, Raynaud's phenomenon, Esophageal dysfunction, Sclerodactyly, and Telangiectasia) syndrome experiencing severe GI involvement who presented to the emergency department with hypoxic respiratory failure and acute kidney injury. The patient and her family finally made the decision to transition to inpatient hospice care, focusing on comfort and dignity, leading to the patient's peaceful passing.