Tatsuno Mizuki, Koganei Kazutaka, Tatsumi Kenji, Kuroki Hirosuke, Obara Nao, Saitoh Sayumi, Sugita Akira
Department of Inflammatory Bowel Disease, Yokohama Municipal Citizen's Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2023;120(8):680-688. doi: 10.11405/nisshoshi.120.680.
A 57-year-old man presenting with severe ulcerative colitis (UC) complicated by disseminated intravascular coagulation (DIC) was referred to our hospital. Since it was difficult to improve DIC immediately with any medical treatment, total proctocolectomy, ileoanal canal anastomosis, and ileostomy were performed on the patient. Soon after the surgery, his platelet count and coagulability improved, and he recovered from DIC. Thus, when the cause of DIC is probably UC itself, and medical treatment has limited efficacy in improving the DIC, surgery should be performed as soon as possible to eliminate the cause of DIC, considering the general condition of the patient.
一名57岁男性因严重溃疡性结肠炎(UC)并发弥散性血管内凝血(DIC)被转诊至我院。由于任何药物治疗都难以立即改善DIC,遂对该患者实施了全直肠结肠切除术、回肠肛管吻合术和回肠造口术。术后不久,他的血小板计数和凝血功能得到改善,DIC也随之恢复。因此,当DIC的病因可能是UC本身,且药物治疗改善DIC的效果有限时,应根据患者的一般情况,尽快进行手术以消除DIC的病因。