Kumaravel Kanagavelu Aravind Sunderavel, Khani Aria, Boloorsazmashadi Roxanne, Khan Rimsha, Langmead Louise, Mehta Shameer
Gastroenterology, Barts Health NHS Trust, London, GBR.
Cureus. 2024 Nov 17;16(11):e73837. doi: 10.7759/cureus.73837. eCollection 2024 Nov.
Ulcerative colitis (UC) is a chronic immune-mediated intestinal condition. This case report describes an 82-year-old woman who was newly diagnosed with UC. Two years prior, she had multiple admissions for abdominal pain and rectal bleeding, initially diagnosed as diverticulitis. Following Hartmann's procedure for a sealed perforation, she developed diversion colitis. Subsequent symptoms included abdominal pain, vomiting, and high stoma output, with CT imaging revealing upstream colitis and para-stomal cellulitis. Biopsies confirmed severe inflammation and ulceration consistent with UC. The patient was treated with intravenous hydrocortisone, but her symptoms rebounded upon steroid tapering. Vedolizumab was considered due to her venous thromboembolism (VTE) risk. Post-treatment, her stoma output and skin irritation improved. This case supports the theory that diversion colitis may predispose individuals to developing UC.
溃疡性结肠炎（UC）是一种慢性免疫介导的肠道疾病。本病例报告描述了一名82岁新诊断为UC的女性。两年前，她因腹痛和直肠出血多次入院，最初被诊断为憩室炎。在因封闭性穿孔接受哈特曼手术后，她患上了改道性结肠炎。随后的症状包括腹痛、呕吐和高造口排出量，CT成像显示上游结肠炎和造口旁蜂窝织炎。活检证实存在与UC一致的严重炎症和溃疡。患者接受了静脉注射氢化可的松治疗，但在类固醇减量时症状复发。考虑到她有静脉血栓栓塞（VTE）风险，给予了维多珠单抗治疗。治疗后，她的造口排出量和皮肤刺激症状有所改善。本病例支持改道性结肠炎可能使个体易患UC这一理论。
