Fatal ulcerative panenteritis following colectomy in a patient with ulcerative colitis

Vito Annese, Nazario Caruso, Michele Bisceglia, Giovanni Lombardi, Rocco Clemente, Giovanni Modola, Berardino Tardio, Maria Rosaria Villani, Angelo Andriulli

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

A 37-year-old man, previously submitted to colectomy for ulcerative pancolitis unresponsive to medical therapy, presented with nausea, vomiting, epigastric pain, and bloody diarrhea. An upper gastrointestinal endoscopy revealed mucosal friability, petechiae, and erosions throughout the duodenum, whereas prestomal ileum showed large ulcers and pseudopolyps. Histologically, a dense inflammation chiefly composed of lymphocytes and plasma cells with few neutrophils was detected. No bacteria, protozoa, and fungi could be detected. Despite intensive care, intravenous antibiotics and steroids, the patient died of diffuse intravascular coagulation and multiorgan failure. At post-mortem examination severe ulcerative lesions were observed scattered throughout the duodenum up to the distal ileum. The dramatic clinical presentation with fatal outcome, the widespread ulcers throughout the intestine, and the histological picture are peculiar features in our patient which can not be ascribed to any type of the ulcerative jejunoenteritis so far reported. Patients with pancolitis and diffuse ileal involvement do not necessarily have Crohn's disease but rather may have ulcerative colitis.

Original languageEnglish
Pages (from-to)1189-1195
Number of pages7
JournalDigestive Diseases and Sciences
Volume44
Issue number6
DOIs
Publication statusPublished - 1999

Fingerprint

Colectomy
Ulcerative Colitis
Ileum
Duodenum
Ulcer
Gastrointestinal Endoscopy
Purpura
Fatal Outcome
Critical Care
Plasma Cells
Crohn Disease
Nausea
Intestines
Vomiting
Autopsy
Diarrhea
Neutrophils
Fungi
Steroids
Lymphocytes

Keywords

  • Duodenojejunoenteritis
  • Inflammatory bowel disease
  • Ulcerative colitis
  • Ulcerative enteritis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Fatal ulcerative panenteritis following colectomy in a patient with ulcerative colitis. / Annese, Vito; Caruso, Nazario; Bisceglia, Michele; Lombardi, Giovanni; Clemente, Rocco; Modola, Giovanni; Tardio, Berardino; Villani, Maria Rosaria; Andriulli, Angelo.

In: Digestive Diseases and Sciences, Vol. 44, No. 6, 1999, p. 1189-1195.

Research output: Contribution to journalArticle

Annese, V, Caruso, N, Bisceglia, M, Lombardi, G, Clemente, R, Modola, G, Tardio, B, Villani, MR & Andriulli, A 1999, 'Fatal ulcerative panenteritis following colectomy in a patient with ulcerative colitis', Digestive Diseases and Sciences, vol. 44, no. 6, pp. 1189-1195. https://doi.org/10.1023/A:1026688526551
Annese, Vito ; Caruso, Nazario ; Bisceglia, Michele ; Lombardi, Giovanni ; Clemente, Rocco ; Modola, Giovanni ; Tardio, Berardino ; Villani, Maria Rosaria ; Andriulli, Angelo. / Fatal ulcerative panenteritis following colectomy in a patient with ulcerative colitis. In: Digestive Diseases and Sciences. 1999 ; Vol. 44, No. 6. pp. 1189-1195.
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