Abstract
A 33-year-old previously healthy man presented with ventricular fibrillation due to acute myocardial infarction. The patient was given coronary recanalization therapy under extracorporeal cardiopulmonary resuscitation by using veno arterial extracorporeal membrane oxygenation (VA-ECMO). As a result, his spontaneous circulation returned and he was admitted to the ICU. In the ICU, his hemodynamics stabilized and VA-ECMO was removed. However, he experienced acute kidney injury due to right lower leg compartment syndrome and rhabdomyolysis. Thus, he was treated with continuous hemodiafiltration. After 16 days in the hospital, severe hematochezia was observed. An emergency endoscopy of the sigmoid colon revealed multiple ulcers, which were suspected to be due to ischemic colitis. The hematochezia was uncontrollable; therefore, we urgently performed a left hemicolectomy and then Hartmann's procedure three days later. After 21 days in the hospital, the test results for cytomegalovirus (CMV) antigenemia were positive (6/25,000 cells). Histopathology revealed nuclear inclusions characteristic of CMV enteritis and ganciclovir therapy was initiated. After 32 days in the hospital, we discharged the patient from the ICU. We report a case of colitis presenting with severe hematochezia that developed in a previously healthy adult.
