Abstract
An 84 year-old woman with hypertension, rheumatoid arthritis and reflux esophagitis who was under treatment with, among other drugs, celecoxib and lansoprazole, was referred to our hospital in September 2012 for diagnostic evaluation and treatment of diarrhea and melena. Abdominal examination revealed both rebound tenderness and muscle guarding. Computed tomography revealed ischemic change of the colorectal wall along the long segment, with free air and abscess formation in the retroperitoneum surrounding the descending and sigmoid colon. Under the suspected diagnosis of acute generalized peritonitis secondary to colonic penetration into the retroperitoneum caused by ischemic colitis, we performed emergency surgery, namely, Hartmann’s operation. Histopathology revealed the diagnosis of collagenous colitis. The postoperative course was uneventful, and no relapse of the gastrointestinal hemorrhage was observed until the 12-month follow-up after the surgery in the absence of treatment with either celecoxib or lansoprazole.
