Colonic obstruction due to giant inflammatory polyposis in a patient with ulcerative colitis.
A 32-year-old Japanese woman with a 14-month history of ulcerative colitis (UC), pancolitis type, was referred to our institution, because of abdominal distention. Plain abdominal X-ray and computed tomography (CT) showed marked dilatation of the right side of the colon. The patient was treated by immediate total colectomy, with the diagnosis of toxic megacolon. Macroscopically, there was a constricting lesion with giant polyposis in the middle part of the transverse colon. Histologically, there was transmural inflammation with a thickened proper muscular layer overlaid by inflammatory polyposis. This case suggests that giant polyposis in UC patients may result in severe stenosis and that such a condition should not be misinterpreted as toxic megacolon or as colitic cancer.
Yada
Shinichiro
S
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Matsumoto
Takayuki
T
Kudo
Tetsuji
T
Hirahashi
Minako
M
Yao
Takashi
T
Mibu
Ryuichi
R
Iida
Mitsuo
M
D000328:Adult; D001707:Biopsy, Needle; D003082:Colectomy / Q000379:methods; D003093:Colitis, Ulcerative / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003111:Colonic Polyps / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007415:Intestinal Obstruction / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008532:Megacolon, Toxic / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome