| Severe Ischemic Colitis from Gastric Ulcer Bleeding-Induced Shock in Patient with End Stage Renal Disease Receiving Hemodialysis |
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Byung Wook Yoon, Jong Seol Park, Young Sik Woo, Jaehoon Jahng, Seok Youn Lee, Nurhee Hong, Yong Sung Kim |
1Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea. wms89@hanmail.net
2Department of Surgery, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.
3Department of Radiology, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.
4Wonkwang Digestive Disease Research Institute Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea. |
| 혈액투석 중인 말기신부전 환자에서 위궤양 출혈성 쇼크에 의해 발생한 중증 허혈성 대장염 |
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윤병욱1, 박종설1, 우용식1, 장재훈1, 이석윤2, 홍누리3, 김용성1,4 |
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원광대학교 의과대학 산본병원 내과학교실1, 외과학교실2, 방사선과학교실3, 원광 소화기질환 연구소4 |
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| Abstract |
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Upper gastrointestinal bleeding is a common condition and has various clinical courses and prognosis. End stage renal disease (ESRD) patients receiving hemodialysis have a high risk of vascular complications and increased risk of ischemic colitis. A 59-year-old male patient with ESRD receiving hemodialysis visited due to hematemesis. After admission, he showed recurrent hematemesis and hypovolemic shock. Upper esophagogastroduodenoscopy revealed gastric ulcer bleeding and endoscopic hemostasis was successfully performed. Blood transfusion and norepinephrine was administered for hypovolemic shock during initial 3 days. Ten days later, he exhibited hematochezia. Sigmoidoscopy revealed necrotic ischemic colitis in sigmoid colon and segmental colectomy was performed. However, recurrent leakage and ischemia were developed in colon as well as small bowel, and he finally died after 55 hospital days in spite of additional operations. Here, we report a case of peptic ulcer bleeding in patient with ESRD who suffered a severe form of ischemic colitis with transmural necrosis. |
| Key Words:
Stomach ulcer; Colitis, ischemic; Necrosis; Kidney failure, chronic |
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