title: Acute onset of ulcerative colitis following an operation for sigmoid colon cancer.
abstract: We describe a case of ulcerative colitis (UC) where clinical symptoms began abruptly within a few weeks after colon resection. The patient, a 44-year-old woman, was first referred to our hospital for the treatment of colon cancer. During the past several years, she had not had any inflammatory bowel disease-like clinical symptoms, such as frequent diarrhea or abdominal discomfort. Before the operation, both macroscopic and microscopic examination revealed that no remarkable inflammatory change was associated with the cancer in any area of her colon. At 10 days after the operation, she started to complain of frequent watery diarrhea. Two weeks after the operation, she was readmitted to our hospital because of frequent bloody diarrhea, fever, and abdominal discomfort. Based on endoscopic and histological examinations, she was diagnosed as having severe UC and was treated with hyperalimentation, predonisolone, mesalazine, and granulocyte apheresis. However, she did not respond to this combination therapy. At 45 days after the first operation, owing to sudden onset hemorrhagic shock, she underwent a second colectomy. The resected specimen of the entire colon showed severe pancolitis, and histological examination revealed severe inflammatory changes in the lamina propria together with crypt distortion, all of which were consistent with UC.
authors.affiliation: Department of Gastroenterology, Hachioji Digestive Disease Hospital, 177-3 Yorozu-cho, Hachioji, Tokyo, 192-0903, Japan.
authors.forename: Mihoko
authors.initials: M
authors.lastname: Takakura
authors.forename: Naoko
authors.initials: N
authors.lastname: Mochizuki
authors.forename: Katumi
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Shuji
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konishi
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Takeo
authors.forename: Mamoru
authors.initials: M
authors.lastname: Suzuki
authors.forename: Masanori
authors.initials: M
authors.lastname: Tanaka
mesh_terms: D000208:Acute Disease; D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D003082:Colectomy / Q000009:adverse effects*; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000209:etiology*; D003113:Colonoscopy; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011183:Postoperative Complications; D012811:Sigmoid Neoplasms / Q000601:surgery*