[Hemorrhagic colitis due to Escherichia coli O157 infection in a patient with Takayasu's arteritis].
Escherichia coli (E coli) O157 may cause abdominal pain and diarrhea followed by hematochezia. Most of cases resolve spontaneously after several days. Takayasu's arteritis affects medium- and large-sized arteries, aortic arch and its branch, and rarely affects inferior mesenteric artery. In case of Takayasu's arteritis with hematochezia, we must distinguish among ulcerative colitis, ischemic colitis, and infectious colitis with Takayasu's arteritis. We report a case of 17-year-old woman who suffered from hemorrhagic colitis by E. coli O157, and combined with leg claudication and abdominal pain by Takayasu's arteritis that affected abdominal aorta and inferior mesenteric artery. Sigmoidoscopy showed edematous, hyperemic mucosa and superficial ulcerations in the sigmoid colon. Abdominal CT scan showed diffuse submucosal edema, narrowing of distal abdominal aorta and inferior mesenteric artery. Hematochezia disappeared after the conservative treatment and leg claudication and abdominal pain disappeared after the aortic angioplasty.
Lee
Si Hyung
SH
Department of Internal Medicine, Yeungnam University School of Medicine, Daegu, Korea.
Jang
Byung Ik
BI
Kim
Tae Nyeun
TN
D000293:Adolescent; D000792:Angiography; D003092:Colitis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D004927:Escherichia coli Infections / Q000150:complications / Q000175:diagnosis*; D019453:Escherichia coli O157; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D021621:Imaging, Three-Dimensional; D012812:Sigmoidoscopy; D013625:Takayasu Arteritis / Q000000981:diagnostic imaging* / Q000628:therapy; D036542:Tomography, Spiral Computed