Abstract
Recently we experienced a case of ischemic colitis (IC) occurring in a patient receiving long-term hemodialysis (HD). A 27-year-old man who had been receiving HD for about 9 years suddenly developed abdominal pain and bloody stool several hours after receiving HD. The laboratory data at the onset showed leukocytosis, CRP positive and renal function disorder, but the others were within normal range. Barium enema showed a stenotic and irregular lesion near the hepatic flexure of the transverse colon. Colonofiberscopy examined 3 weeks after the onset showed a stenosis with mucosal edema, bleeding, cobblestone like appearance and longitudinal ulcer. The histopathological findings were severe infiltration of polymorphonuclear cells, f ibroblasts, connective tissues and no granuration tissues among them, which meant nonspecific acute inflammation. Concerning the pathogenesis of this case, we considered that decreased renal plasma flow, unbalansed serum electrolyte and disordered autonomic nervous function in chronic renal failure led to hypertension, heart failure, progression of arteriosclerosis and elevation of intraluminal pressure and furthermore transient hypotension and hypovolemia induced by HD were implicated for the development of IC.
