scholarly journals Cytomegalovirus Colitis Presenting as a Rectal Mass

2017 ◽  
Vol 08 (03) ◽  
pp. 137-139 ◽  
Author(s):  
Aaron Joseph Cohen ◽  
Navin L. Kumar ◽  
Julia Y. McNabb-Baltar

ABSTRACTCytomegalovirus (CMV) is a common cause of colitis, particularly in immunosuppressed patients. Rarely, CMV can present as a mass lesion that endoscopically appears consistent with adenocarcinoma. There are no reported cases of a CMV mass lesion inducing rectal prolapse. We present a case of CMV colitis presenting as a rectal mass mimicking adenocarcinoma and causing rectal prolapse in an immunosuppressed female.

2007 ◽  
Vol 73 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Dorna Rezania ◽  
Abderrhman Ouban ◽  
Jorge Marcet ◽  
Scott Kelley ◽  
Domenico Coppola

The association between cytomegalovirus infection and inflammatory bowel disease challenges both the clinician and the pathologist to establish the correct diagnosis and to prescribe the most appropriate form of therapy. To understand this association the authors report three patients who presented with signs and symptoms mimicking reactivated inflammatory bowel disease who responded poorly to aggressive treatment of inflammatory bowel disease. Microscopic examination, in all three cases revealed numerous nuclear and cytoplasmic viral inclusions, as demonstrated by cytomegalovirus immunohistochemistry, as well as histologic findings consistent with inflammatory bowel disease (ulcerative colitis and/or Crohn's disease). Because the clinical pathologic features of cytomegalovirus colitis and inflammatory bowel disease often overlap, and because of the possible coexistence of cytomegalovirus colitis with idiopathic colitis, the possibility of cytomegalovirus infection should be always considered, so that the most appropriate therapy can be instituted for these patients.


2020 ◽  
Vol 14 (2) ◽  
pp. 279-285
Author(s):  
Kimitoshi Kubo ◽  
Noriko Kimura ◽  
Soichiro Matsuda ◽  
Momoko Tsuda ◽  
Mototsugu Kato

Cytomegalovirus (CMV) colitis with a cobblestone appearance is rare, and its endoscopic and pathological features remain poorly described. A 78-year-old woman was admitted to our hospital for disturbance of consciousness, high-grade fever, and diarrhea occurring up to 7 times a day. Sigmoidoscopy revealed a circumferential ulcer with mucosal defect, an ulcer with a cobblestone appearance extending from the upper rectum to the sigmoid colon, and an irregular ulcer on the lower rectum. She was histopathologically diagnosed with CMV colitis and intravenously treated with ganciclovir (5 mg/kg) for 7 weeks. Colonoscopy after treatment revealed an improvement of the ulcers extending from the rectum to the sigmoid colon, but no significant improvement of her general condition. She died from sepsis 4 months after hospitalization. To our knowledge, this report represents a valuable addition to the CMV literature describing a rare case of CMV colitis with a cobblestone appearance.


2011 ◽  
Vol 22 (3) ◽  
pp. e21-e23 ◽  
Author(s):  
Rajal Khan ◽  
Pam Rudkin ◽  
Kuljit Grewal ◽  
Jennifer Leonard ◽  
Mowafak Hamodat ◽  
...  

The present report describes the first recognized case of cytomegalovirus (CMV) colitis following azacitidine therapy. A 66-year-old woman with myelodysplastic syndrome developed CMV colitis, which responded to treatment with ganciclovir. Currently, patients receiving azacitidine do not undergo CMV testing, or receive prophylaxis or CMV-free blood products; however, this policy needs to be revised.


ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Jacopo Martellucci ◽  
Serenella Civitelli ◽  
Gabriello Tanzini

Submucosal lipomas of the large bowel are uncommon. Occasionally, they occur in the rectum and may cause aspecific symptoms; presentation with rectal prolapse is very unusual and may lead to a misdiagnosis of simple mucosal prolapse. The paper describes an additional case of a prolapsing rectal mass that led to diagnosis and surgical treatment of a rectal lipoma under local anesthesia.


Diagnostics ◽  
2018 ◽  
Vol 9 (1) ◽  
pp. 3 ◽  
Author(s):  
Anna Kjaer ◽  
Iben Ribberholt ◽  
Kim Thomsen ◽  
Per Ibsen ◽  
Elena Markova ◽  
...  

We present a case demonstrating the diagnostic work-up of a patient undergoing azathioprine treatment for inflammatory bowel disease (IBD), diagnosed with an acute cytomegalovirus (CMV) infection and CMV colitis. An 18F-FDG positron emission tomography/computed tomography (PET/CT) performed 2 weeks after debut of symptoms revealed pathological 18F-FDG uptake in the left side of the colon mucosa, mimicked activity of IBD. However, a diagnosis of CMV colitis was based on the presence of CMV IgM antibodies, a seroconversion of CMV IgG antibodies, presence of CMV DNA in plasma and the finding af CMV DNA in biopsies from the intestinal mucosa. The patient responded to treatment with ganciclovir. This case highlights that a positive 18F-FDG PET/CT scan of the colon can be due to CMV colitis.


2003 ◽  
Vol 17 (12) ◽  
pp. 722-725 ◽  
Author(s):  
Christopher N Andrews ◽  
Paul L Beck

Cytomegalovirus (CMV)-associated colitis can result in abdominal pain, diarrhea, significant blood loss and perforation. The standard therapy for CMV colitis includes supportive measures and antiviral medications. Severe hemorrhage due to CMV colitis often necessitates surgical resection. We present a case of a patient who was undergoing chemotherapy for acute B-cell lymphoblastic leukemia and developed significant abdominal pain and diarrhea followed by massive hematochezia. Colonoscopy showed numerous actively bleeding deep ulcers in the cecum. A provisional diagnosis of CMV colitis was made and she was started on ganciclovir. Histological assessment confirmed the diagnosis of CMV colitis. She continued to bleed profusely per rectum over the following five days, passing up to 1 L to 1.5 L of blood per day. She required 10 units of packed red blood cells over this time period. The patient refused surgical intervention and after discussion of possible options, octreotide was instituted. Her blood loss stopped almost immediately and she required no further transfusions. She tolerated the medication well and was discharged home at a later date in stable condition. This is the first reported case of the use of octreotide in the treatment of massive hematochezia from CMV colitis.


2017 ◽  
Vol 08 (04) ◽  
pp. 193-195
Author(s):  
Ankur Gupta ◽  
Priyanka Jain

ABSTRACTCytomegalovirus (CMV) colitis usually affects immunocompromised hosts. We report a patient with type 2 diabetes mellitus who presented with massive lower gastrointestinal bleed due to CMV colitis, which proved to be fatal. Awareness about this life-threatening entity is important in patients who have impaired immune response.


2018 ◽  
Vol 36 ◽  
pp. 264-266 ◽  
Author(s):  
Kamal Pandit ◽  
Suman Khanal ◽  
Shekhar Bhatta ◽  
Andrew B. Trotter

2019 ◽  
Vol 23 (11) ◽  
pp. 1065-1072 ◽  
Author(s):  
M. Alwahid ◽  
S. R. Knight ◽  
H. Wadhawan ◽  
K. L. Campbell ◽  
D. Ziyaie ◽  
...  

Abstract Background Rectal prolapse is a disease presentation with a prevalence of about 1%, mainly affecting older women. It usually presents with symptoms of rectal mass, rectal bleeding, fecal incontinence or constipation, with patients frequently feeling socially isolated as a result. Perineal rectosigmoidectomy is associated with lesser morbidity and mortality than the abdominal procedure, but with a much higher recurrence rate. Therefore, this technique is mainly suitable for the frail elderly patient. Specific outcomes in an elderly population have been described in only a few studies. We evaluated the morbidity, mortality, recurrence rate and functional results after this procedure related to age. Methods All patients who underwent a perineal rectosigmoidectomy over a 10-year period in two tertiary referral centers were included in the study. American Society of Anesthesiology (ASA) grade, pre- and postoperative symptoms, pathology-reported post-fixation specimen length, length of in-patient stay, 30-day morbidity/mortality, and recurrence were measured. Results A total of 45 patients underwent a perineal rectosigmoidectomy. Forty-three (95%) were female, with a median age of 82.0 years (IQR 70.5–86.5), ASA grade III and median follow-up of 20 months (range 8.5–45.5 months). Half of the cohort was over 80 years old. Significant symptomatic relief was achieved, predominantly the resolution of rectal mass (8.9% vs. 60.0% preoperatively), fecal incontinence (15.6% vs. 46.7%) and constipation (4.4% vs. 26.7%). The median length of stay was 6 days, while morbidity occurred in 14 patients (31.1%) and recurrence occurred in 6 patients (13%). There were no deaths within 30 days of the procedure and outcomes were comparable in the < 80 and ≥ 80 age group. Conclusions Perineal rectosigmoidectomy is safe for older patients with greater comorbidities resulting in good functional results and is associated with low morbidity and mortality.


Sign in / Sign up

Export Citation Format

Share Document