Abstract
A 68-year-old female frequently had abdominal pain that was relieved by defecation. One day she developed severe abdominal pain and was taken to hospital by ambulance this May. She had right upper quadrant tenderness and rebound tenderness. Abdominal computed tomography(CT) showed bowel wall thickening and extraintestinal gas in the mesentery around the sigmoid and descending colon, and emergency surgery was performed. On laparotomy, the transition site between the sigmoid and the descending colon was red and imflamed ; small air bubbles were found in the adjecent mesentery, ; no perforation was apparent. The patient had a partial resection of the descending colon and a colostomy. On macroscopic examination, a longitudinal ulcer that extended the entire length of the resected specimen was noted. Since on histopathology a subepithelial collagen band, more than 20μm thick, was identified, collagenous colitis was diagnosed. On detailed history, it was found out that she had been prescribed lansoprazole about a year prior to the current admission. After the operation, her symptoms continued unabated despite stopping lansoprazole. Therefore, mesalazine was given.
