Desai Meeta, Reiprich Aaron, Khov Nancy, Yang Zhaohai, Mathew Abraham, Levenick John
Department of Internal Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pa., USA.
Department of Internal Medicine, Pinnacle Health, Harrisburg, Pa., USA.
Case Rep Gastroenterol. 2016 Jun 27;10(2):332-7. doi: 10.1159/000446575. eCollection 2016 May-Aug.
Lower GI bleeding is a common cause for hospitalization in adults. Medication-associated mucosal injury is an important clinical entity that can result in significant morbidity and mortality. We present the case of a 45-year-old woman with a 3-month history of intermittent abdominal cramping and rectal bleeding. Her medical history was extensive and included end-stage renal disease and a remote history of endometrial carcinoma that was treated with radiation. Initial workup was concerning for ischemic and radiation colitis, however, histology was most consistent with acute inflammation and ulceration associated with crystal fragments. Sevelamer and cholestyramine are commonly used ion-exchange resins that have been associated with mucosal damage. Both medications were discontinued and her symptoms resolved. Our case highlights an underrecognized but important cause of hematochezia.
下消化道出血是成人住院的常见原因。药物相关的黏膜损伤是一种重要的临床病症，可导致严重的发病率和死亡率。我们报告一例45岁女性病例，她有3个月间歇性腹部绞痛和直肠出血的病史。她的病史复杂，包括终末期肾病以及既往接受过放射治疗的子宫内膜癌病史。初步检查怀疑为缺血性结肠炎和放射性结肠炎，然而，组织学检查结果最符合与晶体碎片相关的急性炎症和溃疡。司维拉姆和考来烯胺是常用的离子交换树脂，它们与黏膜损伤有关。两种药物均已停用，她的症状得以缓解。我们的病例突出了一个未被充分认识但重要的便血原因。
