ABSTRACT
A 73-year-old woman developed ulcerative colitis with mesalazine intolerance a year ago. She relapsed 10 months later. Although she was in clinical remission with salazosulfapyridine (SASP) and prednisolone administration, she developed agranulocytosis 53 days following SASP administration. She went into septic shock;however, she recovered with antibiotics, granulocyte colony-stimulating factor, and cardiotonic agents. Drug-induced lymphocyte stimulation test was positive for both mesalazine and SASP. Drug selection should be carefully determined in patients with 5-aminosalicylic acid intolerance.
Subject(s)
Agranulocytosis , Colitis, Ulcerative , Shock, Septic , Female , Humans , Aged , Colitis, Ulcerative/drug therapy , Mesalamine/adverse effects , Sulfasalazine/adverse effects , Agranulocytosis/chemically inducedABSTRACT
There are various reconstruction techniques that are used after upper gastrointestinal surgery. In recent years, opportunities for endoscopic diagnosis and treatment have been increasing in patients undergoing gastrointestinal surgery. With the advent of interventional endoscopic ultrasound (IV-EUS), various procedures have been developed mainly for patients in whom endoscopic retrograde cholangiopancreatography is difficult to carry out. Indications for such procedures are expanding. IV-EUS for surgically altered anatomy (SAA) includes EUS-guided fine-needle aspiration, biliary interventions (e.g. biliary drainage, treatment of bile duct stricture, removal of bile duct stones, and the rendezvous technique), and pancreatic interventions (e.g. rendezvous technique after Whipple surgery). In addition, there have been reports of various EUS-related procedures using a forward-viewing curved linear-array echoendoscope that are carried out for postoperative intestinal tract reconstruction. Although interventional EUS is a useful therapeutic procedure for SAA, there are still no dedicated devices, and standardization of the procedure is warranted.