Zimbwa, Truman Austin, Owen, R., Thomas, G., Hargest, Rachel  ORCID: https://orcid.org/0000-0001-9830-3832 and Williams, Geraint Trefor ORCID: https://orcid.org/0000-0003-3768-9940
2010.
An unusual complication of colitis.
Gut
59
(3)
, p. 364.
10.1136/gut.2009.179689
|
Abstract
An 18-year-old man with a 13 month history of ulcerative coltis (UC) was admitted with a progressive history of worsening left-sided abdominal pain, diarrhoea, rectal bleeding and weight loss. UC had been diagnosed on flexible sigmiodoscopy and biopsies, which confirmed moderately active colitis to the point of insertion (distal descending colon). Initially he was commenced on mesalazine and steroids, but his disease remained active and azathioprine was introduced after 4 months. Despite this he continued to suffer active symptoms, and a colonoscopy was performed after 8 months. This demonstrated some improvement, with mildly active colitis evident to the sigmoid. The full extent of his colitis was not established as the procedure was limited to the sigmoid because of patient discomfort. Over the next 4 months his condition and blood tests gradually worsened to the point that he required admission. On examination, he was feverish and tachycardiac. Abdominal palpation demonstrated a left lower quadrant “mass” and tenderness, but no guarding. Laboratory analysis identified a microcytic anaemia (haemoglobin 5.6 g/dl), normal white cell count, elevated platelet count (666×109/l), raised C-reactive protein (199 mg/l) and a low albumin (23 g/dl). An abdominal radiograph showed right-sided faecal loading. He failed to improve, despite treatment with hydrocortisone and intravenously, and a CT scan of his abdomen and pelvis was requested (figure 1).
| Item Type: | Article |
|---|---|
| Date Type: | Publication |
| Status: | Published |
| Schools: | Medicine |
| Subjects: | R Medicine > R Medicine (General) |
| Additional Information: | Editor's quiz: GI snapshot |
| Publisher: | BMJ Publishing Group |
| ISSN: | 0017-5749 |
| Related URLs: | |
| Last Modified: | 20 Oct 2022 08:18 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/27924 |
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