Two Cases of Severe Ulcerative Colitis with Colonic Dilatation Resolved with Tacrolimus Therapy.
We report 2 cases of ulcerative colitis (UC) with intestinal tract dilatation treated with tacrolimus. They were 53- and 64-year-old males, who had been admitted to local hospitals for increasing severity of their UC symptoms. Treatment for severe UC was immediately started, but both cases were refractory to corticosteroid therapy; they were then transferred to our hospital. When they were referred to our hospital, they had frequent bloody diarrhea, fever, severe abdominal pain, and even dilatation of the transverse colon on abdominal X-ray test. They were treated with oral tacrolimus medication, and their symptoms improved immediately. Dilatation of the transverse colon was improved on plain X-ray at 2 weeks after starting therapy, and emergency colectomy could be avoided. These 2 cases may suggest that tacrolimus is effective for UC with colonic dilatation as a rescue therapy.
Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
Ryohei
R
Hayashi
Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
Yoshitaka
Y
Ueno
Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
Shinji
S
Tanaka
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
Shintaro
S
Sagami
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
Kenta
K
Nagai
Department of Surgery, Hiroshima University Hospital, Hiroshima, Japan.
Norifumi
N
Shigemoto
Department of Surgery, Hiroshima University Hospital, Hiroshima, Japan.
Shinnosuke
S
Uegami
Department of Surgery, Hiroshima University Hospital, Hiroshima, Japan.
Wataru
W
Shimizu
Department of Surgery, Hiroshima University Hospital, Hiroshima, Japan.
Yusuke
Y
Watadani
Department of Surgery, Hiroshima University Hospital, Hiroshima, Japan.
Hiroki
H
Ohge
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
Kazuaki
K
Chayama
Intestinal tract dilatation; Tacrolimus; Toxic megacolon; Ulcerative colitis