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- W2977472653 abstract "Introduction: Ulcerative colitis (UC) has been recognized as a systemic immune disorder that is not as restricted as colitis. Recently, we experienced some cases of UC-related gastrointestinal lesions with bleeding even after colectomy. Almost enteritis rapidly extended and revealed massive bleeding with hypovolemic shock. Therefore, we considered the clinical features and treatment of these UC-related lesions. Methods: We reviewed the patient data in our UC surgery database to evaluate the prevalence and features of UC-related gastro-duodenitis and enteritis. These lesions were defined using endoscopic findings that included friable mucosa, granular mucosa, or conditionally, multiple aphthae with denying a Helicobacter Pylori infection and Crohn's disease. Representative endoscopic findings of severe duodenitis with massive bleeding are shown in figure. Results: We found 24/1,190 patients with UC-related lesions between January 2000 and Dec 2013. These lesions developed at a mean of 24 (range -35-4320) days after colectomy. 7 of the 24 patients suffered from gastrointestinal bleeding as an initial symptom that rapidly developed into massive bleeding or perforations. All of the patients with bleeding were diagnosed with pan-colitis before colectomy; at the time of colectomy, fulminant, severe, moderate, and mild colitis were presented by 4, 1, 1, and 1 patient, respectively. All patients with enteritis had consecutively developed other complications, including anastomotic leakage, pyoderma gangrenosum, wound infection, and pneumonia. Although patients with massive bleeding did not respond to treatment with corticosteroids, they responded well to infliximab soon after its administration. Although 6 of the 7 patients showed cytomegalo virus re-activation in blood or pathological examinations, ganciclovir was not effective in its elimination. Conclusion: Although UC-related lesions with an unknown etiology can occur consecutive to other immune disorder even after colectomy, immediate examination and treatment are required if gastrointestinal bleeding is found after surgery. Because gastrointestinal massive bleeding from UC-related lesions can worsen rapidly and may be related to mortality, early potent biologic therapy should be considered.Figure 1" @default.
- W2977472653 created "2019-10-10" @default.
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- W2977472653 date "2015-10-01" @default.
- W2977472653 modified "2023-10-02" @default.
- W2977472653 title "Clinical Features and Treatment for Ulcerative Colitis-Related Severe Gastroduodenitis and Enteritis After Colectomy" @default.
- W2977472653 doi "https://doi.org/10.14309/00000434-201510001-01806" @default.
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