A Case of a Cytomegalovirus Colitis Related Rectal Stricture Treated by Endoscopic Balloon Dilation.
- Author:
Kwonoh PARK
1
;
Kyung Ho KIM
;
Jong Won PARK
;
Sangho LEE
;
Hyunjung JO
;
Seungyun CHUN
;
Hyewon PARK
;
Hak Yang KIM
Author Information
1. Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea. minsoksumin@yahoo.co.kr
- Publication Type:Case Report
- Keywords:
Cytomegalovirus;
Colitis;
Stricture;
Balloon dilation
- MeSH:
Abdominal Pain;
Accidents, Traffic;
Aged;
Biopsy;
Colitis;
Colon;
Colonoscopy;
Constriction, Pathologic;
Cytomegalovirus;
Diarrhea;
Emergencies;
Female;
Follow-Up Studies;
Gastrointestinal Hemorrhage;
Giant Cells;
Hemorrhage;
Humans;
Iliac Artery;
Immunocompromised Host;
Inclusion Bodies;
Megacolon, Toxic;
Opportunistic Infections;
Orthopedics;
Pelvic Bones;
Phenobarbital;
Rectum;
Rupture;
Ulcer
- From:Korean Journal of Gastrointestinal Endoscopy
2010;41(4):240-244
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Cytomegalovirus (CMV) colitis is a common opportunistic infection in immunocompromised patients. Affected individuals present with abdominal pain, diarrhea, or hematochezia. Complications of CMV colitis can include massive bleeding, toxic megacolon, bowel perforation and, rarely, colon stricture. A 69-year-old woman who had no specific past history was admitted to the orthopedic department for pelvic bone fracture with right iliac artery rupture caused by a traffic accident. She was successfully managed with emergency transarterial coil embolization. After 2 weeks, she developed hematochezia and recurrent abdominal pain. Colonoscopy showed a huge, deep ulcer in the rectosigmoid colon. Biopsy and immunohistochemical staining revealed giant cells with intracellular inclusion bodies that were positive for CMV antigen. She received antiviral treatment after which her symptoms improved. On follow-up colonoscopy 3 months later, we found a tight luminal narrowing in the rectum. We did a repeat endoscopic balloon dilation in this patient and she experienced improvement.
