Abstract
The patient was a 42-year-old female with a past history of systemic lupus erythematosus, who presented to the ER with the chief complaint of melena and lower abdominal pain. She was diagnosed as having hemorrhagic colitis and admitted to the hospital. Colonoscopy performed on day 2 of admission revealed findings suggestive of ischemic colitis and a longitudinal ulcer in the transverse colon. Supportive therapy was ineffective. On day 3 of admission, the patient developed abdominal pain with signs of peritoneal irritation and the systemic inflammatory response syndrome. Abdominal CT scan revealed worsening of the edematous changes of the colon and massive ascites. An emergent laparotomy was performed under the suspicion of peritonitis secondary to necrotic ischemic colitis, and based on the findings, a subtotal colectomy was performed. On day of admission, pathogenic Escherichia coli O-157 and vero toxin were detected in a culture of a mucosal biopsy specimen obtained by colonoscopy. The postoperative course was uneventful, and the patient was discharged on postoperative day 57.
We have reported a case of successful surgical treatment of hemorrhagic colitis caused by enterohemorrhagic E. coli O-157 infection.
