Abstract
We describe a case of ulcerative colitis (UC) where clinical symptoms began abruptly within a few weeks after colon resection. The patient, a 44-year-old woman, was first referred to our hospital for the treatment of colon cancer. During the past several years, she had not had any inflammatory bowel disease-like clinical symptoms, such as frequent diarrhea or abdominal discomfort. Before the operation, both macroscopic and microscopic examination revealed that no remarkable inflammatory change was associated with the cancer in any area of her colon. At 10 days after the operation, she started to complain of frequent watery diarrhea. Two weeks after the operation, she was readmitted to our hospital because of frequent bloody diarrhea, fever, and abdominal discomfort. Based on endoscopic and histological examinations, she was diagnosed as having severe UC and was treated with hyperalimentation, predonisolone, mesalazine, and granulocyte apheresis. However, she did not respond to this combination therapy. At 45 days after the first operation, owing to sudden onset hemorrhagic shock, she underwent a second colectomy. The resected specimen of the entire colon showed severe pancolitis, and histological examination revealed severe inflammatory changes in the lamina propria together with crypt distortion, all of which were consistent with UC.
Similar content being viewed by others
References
BC Morson IMP Dawson DW Day JR Jkass AB Price GT Williams (Eds) (1990) Morson and Dawson's gastrointestinal pathology EditionNumber3rd ed. Blackwell Scientific Oxford 477–549
RH Riddell (1988) Pathology of idiopathic inflammatory bowel disease JB Kirshner RG Shorter (Eds) Inflammatory bowel disease EditionNumber3rd ed. Lea and Febiger Philadelphia 329–50
GR Lumb RHB Protheroe (1958) ArticleTitleUlcerative colitis: a pathologic study of 152 surgical specimens Gastroenterology 34 381–407 Occurrence Handle1:STN:280:CyeD2MrksVY%3D Occurrence Handle13512610
AG Lim FL Langmead RM Feakins DS Rampton (1999) ArticleTitleDiversion colitis. A trigger for ulcerative colitis in the in-stream colon? Gut 44 279–82 Occurrence Handle1:STN:280:DyaK1M7ht12qug%3D%3D Occurrence Handle9895391
K Endo T Miura T Sato A Unoura T Okata H Watanabe et al. (1977) ArticleTitleTwo cases of ulcerative colitis complicating disseminated intravascular coagulation (in Japanese) Nippon Shokakibyo Gakkai Zasshi (Jpn J Gastroenterol) 79 1778–82
K Kobayashi T Arakawa T Kamata K Kitano S Yui M Okuno et al. (1978) ArticleTitleCoagulation studies in ulcerative colitis (in Japanese) Nippon Shokakibyo Gakkai Zasshi (Jpn J Gastroenterol) 75 232–8 Occurrence Handle1:STN:280:CSeC1MjktlI%3D
Y Usui (1987) ArticleTitleClinical and radiological studies on radiological signs of ischemic colitis in patients with ulcerative colitis (in Japanese with English abstract) Juntendoigaku 33 397–405
H Ohi T Shimaoka Y Nishimata H Nishimata A Shinbara S Matuda et al. (1998) ArticleTitleMorphological study of atypical findings with ulcerative colitis–longitudinal ulcer (in Japanese with English abstract) Stomach Intestine 33 1227–42
M Tanaka RH Riddell (1990) ArticleTitleThe pathological diagnosis and differential diagnosis of Crohn's disease Hepatogastroenterology 37 18–31 Occurrence Handle1:STN:280:By%2BC1crlsVw%3D Occurrence Handle2179090
MK Theis EJ Boyko (1994) ArticleTitlePatient's perception of courses of inflammatory bowel disease Am J Gastroenterol 89 397–404
TB Herbert S Cohen (1993) ArticleTitleStress and immunity in humans: a metaanalytic review Psychosom Med 55 364–79 Occurrence Handle1:STN:280:ByuD383otV0%3D Occurrence Handle8416086
SA Riley V Mani MJ Goodman S Lucus (1990) ArticleTitleWhy do patients with ulcerative colitis relapse? Gut 31 179–83 Occurrence Handle1:STN:280:By%2BC1crjvFI%3D Occurrence Handle2311975
S Levenstein C Prantera V Varvo ML Scribano A Andreoli C Luzi et al. (2000) ArticleTitleStress and exacerbation in ulcerative colitis: a prospective study of patients enrolled in remission Am J Gastroenterol 95 1213–20 Occurrence Handle10.1111/j.1572-0241.2000.02012.x Occurrence Handle1:STN:280:DC%2BD3c3mvFCltQ%3D%3D Occurrence Handle10811330
A Bitton MJ Sewitch MA Peppercorn MD deB Edwardes S Shah B Ransil et al. (2003) ArticleTitlePsychosocial determinants of relapse in ulcerative colitis: a longitudinal study Am J Gastroenterol 98 2203–7 Occurrence Handle10.1111/j.1572-0241.2003.07717.x Occurrence Handle14572569
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Takakura, M., Mochizuki, N., Yamauchi, K. et al. Acute onset of ulcerative colitis following an operation for sigmoid colon cancer. J Gastroenterol 41, 77–82 (2006). https://doi.org/10.1007/s00535-005-1725-6
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s00535-005-1725-6