抄録
A 60-year-old female on chronic hemodialysis for 15 years was hospitalized because of abdominal pain, diarrhea and melena just after she took antibiotics, Sefdinir®. Colonoscopy demonstrated longitudinal ulcers at the terminal ileum, irregular shaped ulcers at cecum and punched out ulcers at the ascending colon. Stool culture disclosed Klebsiella oxytoca. The melena ceased and the intestinal ulcers healed spontaneously after 4 days of conservative therapy then she was discharged. Three month after the episode, without antibiotics intake, she experienced melena again and colonoscopy disclosed flare-up of the ulcers at cecum. Stool culture was negative for Krebsiella oxytoca this time. Recurrence of the ischemic colitis was mostly suspected.
Twenty-six cases of hemodialysis associated ischemic colitis were reported in Japan. Only one case had the recurrence. The characteristics of the ischemic colitis associated with hemodialysis were involvement of the right sided colon and necrotic lesions compared with involvement of the left sided colon and non-necrotic lesions are common in ordinary ischemic colitis.
