Résumé
Terlipressin, a vasopressin agonist, is widely used to treat variceal bleeding and hepatorenal syndrome in patients with liver cirrhosis. Terlipressin increases systemic vascular resistance, particularly in the splanchnic area, thus decreasing portal pressure. Although terlipressin is associated with a lower incidence of severe cardiovascular complications than is vasopressin, terlipressin can induce serious ischemic complications including myocardial infarction, skin necrosis, and bowel ischemia in < 1% of patients. We report the case of a 79-year-old female with liver cirrhosis treated with terlipressin to control hepatorenal syndrome that developed into ischemic colitis. The patient improved upon cessation of terlipressin and provision of supportive care.
Sujets)
Sujet âgé , Femelle , Humains , Colite ischémique , Varices oesophagiennes et gastriques , Syndrome hépatorénal , Incidence , Ischémie , Cirrhose du foie , Infarctus du myocarde , Nécrose , Pression portale , Peau , Résistance vasculaire , VasopressinesRésumé
A 57-year-old man with chronic kidney disease and a history of using numerous herbal medications visited Inje University Ilsan Paik Hospital for abdominal pain and vomiting. An abdominal radiograph showed diffuse small bowel distension containing multiple air-fluid levels and extensive calcifications along the colon. Computed tomography showed colon wall thickening with diffuse calcification along the colonic mesenteric vein and colonic wall. Colonoscopy, performed without bowel preparation, showed bluish edematous mucosa from the transverse to the distal sigmoid colon, with multiple scar changes. At the mid transverse colon, a stricture was noted and the scope could not pass through. A biopsy of the stricture site revealed nonspecific changes. The patient was diagnosed with phlebosclerotic colitis. After the colonoscopy, the obstructive ileus spontaneously resolved, and the patient was discharged without an operation. Currently, after 2 months of follow-up, the patient has remained asymptomatic. Herein, we report the rare case of an obstructive ileus caused by phlebosclerotic colitis with a colon stricture.
Sujets)
Humains , Adulte d'âge moyen , Douleur abdominale , Biopsie , Cicatrice , Colite , Côlon , Côlon sigmoïde , Côlon transverse , Coloscopie , Sténose pathologique , Études de suivi , Science des plantes médicinales , Iléus , Veines mésentériques , Muqueuse , Insuffisance rénale chronique , VomissementRésumé
A 57-year-old man with chronic kidney disease and a history of using numerous herbal medications visited Inje University Ilsan Paik Hospital for abdominal pain and vomiting. An abdominal radiograph showed diffuse small bowel distension containing multiple air-fluid levels and extensive calcifications along the colon. Computed tomography showed colon wall thickening with diffuse calcification along the colonic mesenteric vein and colonic wall. Colonoscopy, performed without bowel preparation, showed bluish edematous mucosa from the transverse to the distal sigmoid colon, with multiple scar changes. At the mid transverse colon, a stricture was noted and the scope could not pass through. A biopsy of the stricture site revealed nonspecific changes. The patient was diagnosed with phlebosclerotic colitis. After the colonoscopy, the obstructive ileus spontaneously resolved, and the patient was discharged without an operation. Currently, after 2 months of follow-up, the patient has remained asymptomatic. Herein, we report the rare case of an obstructive ileus caused by phlebosclerotic colitis with a colon stricture.