Korean J Helicobacter Up Gastrointest Res.  2016 Sep;16(3):165-168. 10.7704/kjhugr.2016.16.3.165.

Severe Ischemic Colitis from Gastric Ulcer Bleeding-Induced Shock in Patient with End Stage Renal Disease Receiving Hemodialysis

Affiliations
  • 1Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea. wms89@hanmail.net
  • 2Department of Surgery, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.
  • 3Department of Radiology, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.
  • 4Wonkwang Digestive Disease Research Institute Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.

Abstract

Upper gastrointestinal bleeding is a common condition and has various clinical courses and prognosis. End stage renal disease (ESRD) patients receiving hemodialysis have a high risk of vascular complications and increased risk of ischemic colitis. A 59-year-old male patient with ESRD receiving hemodialysis visited due to hematemesis. After admission, he showed recurrent hematemesis and hypovolemic shock. Upper esophagogastroduodenoscopy revealed gastric ulcer bleeding and endoscopic hemostasis was successfully performed. Blood transfusion and norepinephrine was administered for hypovolemic shock during initial 3 days. Ten days later, he exhibited hematochezia. Sigmoidoscopy revealed necrotic ischemic colitis in sigmoid colon and segmental colectomy was performed. However, recurrent leakage and ischemia were developed in colon as well as small bowel, and he finally died after 55 hospital days in spite of additional operations. Here, we report a case of peptic ulcer bleeding in patient with ESRD who suffered a severe form of ischemic colitis with transmural necrosis.

Keyword

Stomach ulcer; Colitis, ischemic; Necrosis; Kidney failure, chronic

MeSH Terms

Blood Transfusion
Colectomy
Colitis, Ischemic*
Colon
Colon, Sigmoid
Endoscopy, Digestive System
Gastrointestinal Hemorrhage
Hematemesis
Hemorrhage
Hemostasis, Endoscopic
Humans
Ischemia
Kidney Failure, Chronic*
Male
Middle Aged
Necrosis
Norepinephrine
Peptic Ulcer
Prognosis
Renal Dialysis*
Shock*
Sigmoidoscopy
Stomach Ulcer*
Norepinephrine
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