Fatal Ischemic Colitis Secondary to Cytomegalovirus Vasculitis in a Renal Transplantation Patient

一五十六歲女性在腎移植後一個月因發燒及上腹疼痛求診。鋇劑灌腸檢查顯示升結腸呈現不規則狹窄，電腦斷層攝影則顯示升結腸及肝彎曲處腸壁均增厚。患者因病情惡化接受右側結腸切除術，術中發現由升結腸至近端橫結腸處呈現嚴重發炎及壞死。病理報告顯示檢體呈巨細胞感染造成血管栓塞及缺血性壞死。術後患者病情持續惡化，四天後因廣氾性血管內凝血及內出血而死亡。因器官移植及免疫抑制劑之使用病例逐漸增多，對巨細胞感染造成之腸炎能夠早期診斷及治療，以防止病情惡化至缺血性腸炎，如本病例所示，是非常重要的。

關鍵字

巨細胞病毒；免疫抑制；缺血性腸炎；腎移植

並列摘要

A 56-year-old female developed fever and right upper quadrant pain one month after renal transplantation. Computed tomography and barium enema examination revealed irregular thickening and narrowing of the ascending colon extending to the hepatic flexure. Urgent right hemicolectomy was performed as patient's condition deteriorated rapidly. Severe colitis with gangrenous change of ascending colon was evident during the operation. Histopathological examination for the resected specimen revealed cytomegalovirus infection with vasculitis and ischemic colitis. After the development of disseminated intravascular coagulopathy and internal bleeding, the patient unfortunately died four days after operation. Awareness of this rare cause of ischemic colitis is important because of frequent use of immunosuppresants in the organ transplant recipients.

並列關鍵字

Cytomegalovirus ； Immunosuppression ； Ischemic colitis ； Transplantation

國際替代計量

Fatal Ischemic Colitis Secondary to Cytomegalovirus Vasculitis in a Renal Transplantation Patient

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