Korean J Gastrointest Endosc > Volume 39(5); 2009 > Article
Korean Journal of Gastrointestinal Endoscopy 2009;39(5): 280-284.
대량 출혈을 동반한 특발성 만성 궤양성 소장염 1예
김고흔ㆍ정성애ㆍ송현주ㆍ김성은ㆍ심기남ㆍ유 권ㆍ김광호*ㆍ한운섭
이화여자대학교 의학전문대학원 내과학교실, *외과학교실, 병리학교실
A Case of Idiopathic Chronic Ulcerative Enteritis Presenting with Septic Shock
Go Heun Kim, M.D., Sung-Ae Jung, M.D., Hyun Joo Song, M.D., Seong-Eun Kim, M.D., Ki-Nam Shim, M.D., Kwon Yoo, M.D., Kwang-Ho Kim, M.D.* and Woon Sup Han, M.D.
Departments of Internal Medicine, *Surgery and Pathology, Ewha Womans University School of Medicine, Seoul, Korea
Abstract
Idiopathic chronic ulcerative enteritis (ICUE) is a rare disease with a mortality rate exceeding 75%, which manifests as an ulceration of the small bowel in the absence of a recognizable cause. It is diagnosed by biopsy. A 31-year-old man who had a 10-year history of recurrent episodes of abdominal pain was admitted with a 10-day occurrence of abdominal pain and fever. Upper endoscopy showed multiple active ulcers from duodenal second to distal portion. Colonoscopy revealed diffuse ulcerations at the terminal ileum. Colonic findings were normal. The patient was treated with intravenous antibiotics, systemic steroids, and total parenteral nutrition in the intensive care unit. Ten days after admission, the patient fell into shock due to massive hematochezia and underwent an emergency surgical resection, which revealed Meckel's diverticulum. Bleeding was uncontrolled and the following day surgical resection and intraoperative endoscopy of the highly involved jejunum revealed severe ulcerative bleeding. Microscopic examination revealed ulcerations with pseudopolyps and granulation tissue and no evidence of vasculitis, suggestive of ICUE. (Korean J Gastrointest Endosc 2009;39:280-284)
Key Words: Idiopathic chronic ulcerative enteritis
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