Gangrenous Colitis in a Patient with Polypharmacy: A Case Study
Journal of Surgery
Volume 4, Issue 1, February 2016, Pages: 4-7
Received: Jan. 13, 2016; Accepted: Jan. 25, 2016; Published: Feb. 29, 2016
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Authors
Hassan Malik, Hervey Bay Hospital, Queensland, Australia
Sivananthan Suntharalingam, Hervey Bay Hospital, Queensland, Australia
Muhammad Majid Ali, Hervey Bay Hospital, Queensland, Australia
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Abstract
A 20-year-old female, otherwise fit and well, was admitted to intensive care unit intubated with polypharmacy secondary to drug over dose. She developed a seizure episode and a rise in serum lactate within 24 hours of admission, followed by abdominal distension, with metabolic acidosis and a further elevation of serum lactate levels. CT abdomen revealed gangrenous colitis, which was confirmed on laparotomy. The patient underwent subtotal colectomy with end ileostomy, which was further complicated a week later by necrosis of the stoma due to knotting of the small bowel around the ileostomy loop. She underwent another laparotomy, for fixation of internal herniation of small bowel loops as well re-fashioning of the end ileostomy, and had an uneventful recovery. Final pathology of the colon showed ischaemic colitis with mural necrosis, peritonitis and viable resection margins.
Keywords
Young Female, Gangrenous Colitis, Ishaemic Colitis(IC), Polypharmacy, CT, Laparotomy, Ileostomy
To cite this article
Hassan Malik, Sivananthan Suntharalingam, Muhammad Majid Ali, Gangrenous Colitis in a Patient with Polypharmacy: A Case Study, Journal of Surgery. Vol. 4, No. 1, 2016, pp. 4-7. doi: 10.11648/j.js.20160401.12
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Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Gordon PH, Bubrick MP. Mesenteric vascular diseases. In: Gordon PH, Nivatvongs S, editors. Principles and Practice of Surgery for the Colon, Rectum, and Anus. St. Louis, MO: Quality Medical Publishing; 1999. pp. 1067–1093.
[2]
Stamos, M. J. Intestinal ischemia and infarction. In: Mazier W. P., Levien D. H., Luchtefeld M. A., et al, eds. Surgery of the colon, rectum and anus. Philadelphia: WB Saunders; 1995: 685–718.
[3]
Boley SJ, Schwartz S, Lash J, Sternhill V. Reversible vascular occlusion of the colon. Surg Gynecol Obstet. 1963; 116: 53–60.
[4]
Greenwald DA, Brandt LJ. Colonic ischemia. J Clin Gastroenterol. 1998; 27: 122–128.
[5]
Marston A, Pheils MT, Thomas ML, Morson BC. Ischaemic colitis. Gut. 1966; 7(1): 1–15.
[6]
Longo WE, Ballantyne GH, Gusberg RJ. Ischemic colitis: patterns and prognosis. Dis Colon Rectum. 1992; 35(8): 726–730.
[7]
Stamos MJ. Intestinal ischemia and infarction. In: Mazier WP, Levien DH, Luchtefeld MA, Senagore AJ, editors. Surgery of the Colon, Rectum and Anus. Philadelphia: WB Saunders; 1995. pp. 685–718.
[8]
O. A. Preventza, K. Lazarides, M. D. Sawyer Ischemic colitis in young adults: a single-institution experience J Gastrointest Surg, 5 (2001), pp. 388–392
[9]
Koh KS, Danzinger RG. Massive intestinal infarction in young women: complication of use of oral contraceptives? Can Med Assoc J. 1977; 116: 513–515.
[10]
M. S. Cappell Colonic toxicity of administered drugs and chemicals Am J Gastroenterol, 99 (2004), pp. 1175–1190
[11]
Reinus JF, Brandt LJ, Boley SJ. Ischemic diseases of the bowel. Gastroenterol Clin North Am 1990; 19: 319-343
[12]
Habu Y, Tahashi K, Kiyota K, et al. Reevaluation of clinical features of ischemic colitis: analysis of 68 consecutive cases diagnosed by early colonoscopy. Scand J Gastroenterol 1996; 31: 881-886.
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