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A 53-year-old woman who had recently been treated for ulcerative colitis with high-dose prednisone and mercaptopurine was admitted with severe abdominal pain and signs of peritoneal irritation. Colonoscopy, radiography of the small intestine with contrast medium, and surgical exploration of the abdomen revealed fulminant colitis, primarily involving the left colon, but no apparent small-bowel disease. Total colectomy and an ileostomy were performed. On the fifth postoperative day, the patient's clinical condition deteriorated rapidly, with respiratory failure, anuric renal failure, and profound metabolic acidosis. Computed tomography (CT) of the abdomen showed slight dilatation, mesenteric edema, diffuse pneumatosis intestinalis throughout the small . . . [Full Text of this Article] |
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