Extensive extraintestinal manifestations of ulcerative colitis in a patient initially suspected to have disseminated malignancy

2021 ◽  
Vol 14 (11) ◽  
pp. e241163
Author(s):  
Nikolai Juul ◽  
Stig Søgaard Dahl ◽  
Deepthi Jermaly Chiranth ◽  
Luit Penninga

A 44-year-old patient with known ulcerative colitis presented with abdominal pain and an abdominal mass. CT revealed cecal stranding, a mass at the left colonic flexure involving the pancreas and multiple lesions in the lungs, retroperitoneum and liver. The patient had also developed a scalp rash as well as impaired hearing. Biopsies from the abdominal mass and lungs revealed necrotic inflammation, and the clinical suspicion of malignancy could not be ruled out. After further examination, the patient was treated with high-dose steroids, which rapidly reduced the extraintestinal manifestations. Due to a persistent abscess formation at the left colonic flexure and pancreas, the patient was referred to our hospital for a total colectomy. Histology showed acute and chronic inflammation with cryptitis, indicating ulcerative colitis. Our case is a rare presentation of extensive extraintestinal disease in organs such as the lungs and liver, as well as necrotic mass formation at the colon site which mimicked malignancy.

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Norimitsu Shimada ◽  
Hiroki Ohge ◽  
Hiroki Kitagawa ◽  
Kosuke Yoshimura ◽  
Norifumi Shigemoto ◽  
...  

Abstract Background The incidence of postoperative venous thromboembolism (VTE) is high in patients with inflammatory bowel disease. We aimed to analyze the incidence and predictive factors of postoperative VTE in patients with ulcerative colitis. Methods Patients with ulcerative colitis who underwent colon and rectum surgery during 2010–2018 were included. We retrospectively investigated the incidence of postoperative VTE. Results A total of 140 colorectal surgery cases were included. Postoperative VTE was detected in 24 (17.1 %). Portal–mesenteric venous thrombosis was the most frequent VTE (18 cases; 75 %); of these, 15 patients underwent total proctocolectomy (TPC) with ileal pouch–anal anastomosis (IPAA). In univariate analysis, VTE occurred more frequently in patients with neoplasia than in those refractory to medications (27.2 % vs. 12.5 %; p < 0.031). TPC with IPAA was more often associated with VTE development (28 %) than total colectomy (10.5 %) or proctectomy (5.9 %). On logistic regression analysis, TPC with IPAA, total colectomy, long operation time (> 4 h), and high serum D-dimer level (> 5.3 µg/mL) on the day following surgery were identified as predictive risk factors. Conclusions Postoperative VTE occurred frequently and asymptomatically, especially after TPC with IPAA. Serum D-dimer level on the day after surgery may be a useful predictor of VTE.


2021 ◽  
Vol 8 (1) ◽  
pp. e000587
Author(s):  
Giacomo Caio ◽  
Lisa Lungaro ◽  
Fabio Caputo ◽  
Maria Muccinelli ◽  
Maria Caterina Marcello ◽  
...  

Inflammatory bowel diseases such as ulcerative colitis (UC) may be complicated by several extraintestinal manifestations. These involve joints, skin, eyes and less commonly lungs and heart. Myocarditis may result from the toxic effect of drugs (ie, mesalazine) commonly used for the treatment of UC or due to infections (eg, Coxsackieviruses, enteroviruses, adenovirus). Here, we report a case of a 26-year old man affected by UC and complicated by two episodes of myocarditis. Both episodes occurred during two severe exacerbations of UC. However, in both cases the aetiology of myocarditis remains uncertain being ascribable to extraintestinal manifestation, drug toxicity or both.


1977 ◽  
Vol 186 (4) ◽  
pp. 477-480 ◽  
Author(s):  
LESTER W. MARTIN ◽  
CLAUDE LECOULTRE ◽  
WILLIAM K. SCHUBERT

2021 ◽  
pp. 18-19
Author(s):  
Nilima K. Shah ◽  
Ankita Patel ◽  
Umeshkumar Nakum ◽  
Ravindra Patel

Chronic inammatory demyelinating polyneuropathy (CIDP) is a rare complication of Ulcerative colitis and it is uncertain whether it is associated with Ulcerative colitis itself or with its treatment. We describe a case of CIDP-like neuropathy as an initial symptom of Ulcerative colitis. A 17 years old male patient presented with symmetrical weakness of both lower extremities with paresthesia of both hand and feet. With impression of AIDP patient was treated with plasmapheresis and discharged on tapering steroid therapy. After 3 months again presented with bilateral weakness of all four limbs associated with diarrhea and fever. Patient was diagnosed with Ulcerative colitis ,so considering previous episode as 1st episode of CIDP and with rare association with Ulcerative colitis . Patient was treated with high dose of steroids and immunosuppressive therapy. Neurological and gastrointestinal symptoms remarkably improved after treatment.


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