Diffuse gastroduodenitis and enteritis associated with ulcerative colitis and concomitant cytomegalovirus reactivation after total colectomy: report of a case.
Surg Today
; 43(3): 321-4, 2013 Mar.
Article
en En
| MEDLINE
| ID: mdl-22965486
ABSTRACT
We report a rare case of peristomal pyoderma gangrenosum with severe gastroduodenal lesions, developing after total colectomy in a patient with ulcerative colitis and concomitant cytomegalovirus (CMV) enteritis. A 19-year-old man underwent total proctocolectomy with an ileal J-pouch anal anastomosis and diverting ileostomy, after 2 years of ineffective medical treatment. On postoperative day 6, severe peristomal pyoderma gangrenosum developed and progressed rapidly. Maintaining immunosuppressive therapy with corticosteroids for 6 days induced melena from the gastroduodenal lesions and enteritis with concomitant CMV reactivation. The patient required a jejunostomy, after the duodenal and intestinal CMV lesions had caused multiple perforations. Treatment with intensive cytapheresis was ineffective against the associated UC lesions, which healed with infliximab induction. The CMV reactivation was treated effectively with ganciclovir. The patient is being maintained on infliximab every 8 weeks and there has been no sign of recurrence of the gastroduodenitis-associated UC and CMV reactivation.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Colitis Ulcerosa
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Proctocolectomía Restauradora
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Infecciones por Citomegalovirus
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Citomegalovirus
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Duodenitis
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Enteritis
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Gastritis
Tipo de estudio:
Diagnostic_studies
/
Risk_factors_studies
Límite:
Adult
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Humans
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Male
Idioma:
En
Revista:
Surg Today
Año:
2013
Tipo del documento:
Article
País de afiliación:
Japón