Korean J Gastrointest Endosc.  2010 Oct;41(4):240-244.

A Case of a Cytomegalovirus Colitis Related Rectal Stricture Treated by Endoscopic Balloon Dilation

• Park K
• Kim KH
• Park JW
• Lee S
• Jo H
• Chun S
• Park H
• Kim HY

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.

Keyword

Cytomegalovirus; Colitis; Stricture; Balloon dilation

MeSH Terms

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
Phenobarbital