2021 Volume 63 Issue 10 Pages 2199-2206
A 66-year-old man underwent laparoscopic total proctocolectomy with ileal pouch surgery, 9 months after he was diagnosed with ulcerative colitis (UC). He observed blood in the stool on postoperative day 2, and endoscopic examination revealed diffuse erosion and ulceration with mucosal bleeding in both the duodenum and ileum. Despite treatment with intravenous steroids, ganciclovir, and cyclosporin in addition to a blood transfusion, the patient died of hypovolemic shock secondary to massive hemorrhage. Pathological evaluation revealed severe duodenitis and jejunoileitis. Histopathological examination showed findings consistent with UC-induced enteritis as opposed to those associated with infection, Crohnʼs disease, or ischemic enteritis. Early evaluation and prompt treatment are warranted in patients with persistent gastrointestinal bleeding after colectomy for UC because these lesions can cause massive bleeding.
