Anticoagulation therapy dramatically improved severe sigmoiditis with findings resembling inflammatory bowel disease, which was caused by mesenteric venous thrombosis

Yohei Mikami, Takanori Kanai, Eisuke Iwasaki, Makoto Naganuma, Yoshiyuki Yamagishi, Masayuki Shimoda, Katsuyoshi Matsuoka, Tadakazu Hisamatsu, Yasushi Iwao, Haruhiko Ogata, Seishi Nakatsuka, Makio Mukai, Toshifumi Hibi

Research output: Contribution to journalArticle

Abstract

Mesenteric venous thrombosis is an insidious disease, with a high mortality rate typically attributed to the long delay in diagnosis. Rapid diagnosis and treatment are important. Here, we present a patient with idiopathic inferior mesenteric venous (IMV) thrombosis. A 65-year-old man presented with constant abdominal pain associated with fever and bloody diarrhea. He was diagnosed with severe ulcerative colitis and was treated with mesalazine and prednisolone. The prednisolone was tapered because of liver dysfunction, and he received total parenteral nutrition for a month. His abdominal pain and bloody diarrhea worsened, and he lost 5 kg of weight. He was then transferred to our institute. Computed tomography showed thickening of the left colon. Colonoscopy showed diffuse colitis with multiple ulcers, large edematous folds, congested mucosa, and stenosis of the sigmoid colon, with sparing of the rectum, raising the possibility of IMV thrombosis. Angiography confirmed IMV thrombosis. Anticoagulation therapy was initiated with intravenous heparin followed by oral warfarin. His abdominal pain and diarrhea resolved, and he was discharged from hospital. Six months later, he remained asymptomatic with normal colonoscopic findings.

Original languageEnglish
Pages (from-to)377-382
Number of pages6
JournalClinical Journal of Gastroenterology
Volume5
Issue number6
DOIs
Publication statusPublished - 2012 Dec

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Inflammatory Bowel Diseases
Abdominal Pain
Diarrhea
Prednisolone
Mesalamine
Total Parenteral Nutrition
Sigmoid Colon
Warfarin
Colitis
Colonoscopy
Therapeutics
Ulcerative Colitis
Rectum
Ulcer
Heparin
Liver Diseases
Angiography
Pathologic Constriction
Colon
Mucous Membrane

Keywords

  • Chronic diarrhea
  • Colonoscopy
  • Inflammation
  • Inflammatory bowel disease
  • Venous thrombosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Anticoagulation therapy dramatically improved severe sigmoiditis with findings resembling inflammatory bowel disease, which was caused by mesenteric venous thrombosis",
abstract = "Mesenteric venous thrombosis is an insidious disease, with a high mortality rate typically attributed to the long delay in diagnosis. Rapid diagnosis and treatment are important. Here, we present a patient with idiopathic inferior mesenteric venous (IMV) thrombosis. A 65-year-old man presented with constant abdominal pain associated with fever and bloody diarrhea. He was diagnosed with severe ulcerative colitis and was treated with mesalazine and prednisolone. The prednisolone was tapered because of liver dysfunction, and he received total parenteral nutrition for a month. His abdominal pain and bloody diarrhea worsened, and he lost 5 kg of weight. He was then transferred to our institute. Computed tomography showed thickening of the left colon. Colonoscopy showed diffuse colitis with multiple ulcers, large edematous folds, congested mucosa, and stenosis of the sigmoid colon, with sparing of the rectum, raising the possibility of IMV thrombosis. Angiography confirmed IMV thrombosis. Anticoagulation therapy was initiated with intravenous heparin followed by oral warfarin. His abdominal pain and diarrhea resolved, and he was discharged from hospital. Six months later, he remained asymptomatic with normal colonoscopic findings.",
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author = "Yohei Mikami and Takanori Kanai and Eisuke Iwasaki and Makoto Naganuma and Yoshiyuki Yamagishi and Masayuki Shimoda and Katsuyoshi Matsuoka and Tadakazu Hisamatsu and Yasushi Iwao and Haruhiko Ogata and Seishi Nakatsuka and Makio Mukai and Toshifumi Hibi",
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T1 - Anticoagulation therapy dramatically improved severe sigmoiditis with findings resembling inflammatory bowel disease, which was caused by mesenteric venous thrombosis

AU - Mikami, Yohei

AU - Kanai, Takanori

AU - Iwasaki, Eisuke

AU - Naganuma, Makoto

AU - Yamagishi, Yoshiyuki

AU - Shimoda, Masayuki

AU - Matsuoka, Katsuyoshi

AU - Hisamatsu, Tadakazu

AU - Iwao, Yasushi

AU - Ogata, Haruhiko

AU - Nakatsuka, Seishi

AU - Mukai, Makio

AU - Hibi, Toshifumi

PY - 2012/12

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N2 - Mesenteric venous thrombosis is an insidious disease, with a high mortality rate typically attributed to the long delay in diagnosis. Rapid diagnosis and treatment are important. Here, we present a patient with idiopathic inferior mesenteric venous (IMV) thrombosis. A 65-year-old man presented with constant abdominal pain associated with fever and bloody diarrhea. He was diagnosed with severe ulcerative colitis and was treated with mesalazine and prednisolone. The prednisolone was tapered because of liver dysfunction, and he received total parenteral nutrition for a month. His abdominal pain and bloody diarrhea worsened, and he lost 5 kg of weight. He was then transferred to our institute. Computed tomography showed thickening of the left colon. Colonoscopy showed diffuse colitis with multiple ulcers, large edematous folds, congested mucosa, and stenosis of the sigmoid colon, with sparing of the rectum, raising the possibility of IMV thrombosis. Angiography confirmed IMV thrombosis. Anticoagulation therapy was initiated with intravenous heparin followed by oral warfarin. His abdominal pain and diarrhea resolved, and he was discharged from hospital. Six months later, he remained asymptomatic with normal colonoscopic findings.

AB - Mesenteric venous thrombosis is an insidious disease, with a high mortality rate typically attributed to the long delay in diagnosis. Rapid diagnosis and treatment are important. Here, we present a patient with idiopathic inferior mesenteric venous (IMV) thrombosis. A 65-year-old man presented with constant abdominal pain associated with fever and bloody diarrhea. He was diagnosed with severe ulcerative colitis and was treated with mesalazine and prednisolone. The prednisolone was tapered because of liver dysfunction, and he received total parenteral nutrition for a month. His abdominal pain and bloody diarrhea worsened, and he lost 5 kg of weight. He was then transferred to our institute. Computed tomography showed thickening of the left colon. Colonoscopy showed diffuse colitis with multiple ulcers, large edematous folds, congested mucosa, and stenosis of the sigmoid colon, with sparing of the rectum, raising the possibility of IMV thrombosis. Angiography confirmed IMV thrombosis. Anticoagulation therapy was initiated with intravenous heparin followed by oral warfarin. His abdominal pain and diarrhea resolved, and he was discharged from hospital. Six months later, he remained asymptomatic with normal colonoscopic findings.

KW - Chronic diarrhea

KW - Colonoscopy

KW - Inflammation

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KW - Venous thrombosis

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