title: A patient who survived total colonic type ulcerative colitis complicated by toxic megacolon, disseminated intravascular coagulation, methicillin-resistant Staphylococcus aureus infection and bilateral femoral phlebothrombosis.
abstract: We report a patient who survived total colonic type ulcerative colitis (UC) complicated by toxic megacolon (TM), disseminated intravascular coagulation (DIC), methicillin-resistant Staphylococcus aureus infection, and phlebothrombosis. A 69-year-old man was treated for about 4 months under the diagnosis of ischemic colitis at another hospital, and was transferred to our hospital. Based on endoscopic and pathological findings, we strongly suspected UC, and administered salazosulfapyridine and methylprednisolone, but TM and DIC developed, necessitating urgent subtotal colectomy. Despite his elderly age and the severe complications, he recovered and was discharged from our hospital about 4 months after admission. The mortality rate of UC complicated by TM and DIC in elderly patients is high, necessitating rapid initiation of high-dose steroid administration or surgical treatment.
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Arai
authors.forename: H
authors.initials: H
authors.lastname: Hanai
authors.forename: T
authors.initials: T
authors.lastname: Furuta
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.forename: M
authors.initials: M
authors.lastname: Yamada
authors.forename: E
authors.initials: E
authors.lastname: Kaneko
authors.forename: S
authors.initials: S
authors.lastname: Baba
authors.forename: H
authors.initials: H
authors.lastname: Sugimura
mesh_terms: D000368:Aged; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D018572:Disease-Free Survival; D004211:Disseminated Intravascular Coagulation / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005268:Femoral Vein; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008532:Megacolon, Toxic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy