Escherichia Coli O 157: H7-associated Colitis-Observation of Colonoscopic and Radiographic Course, Report of a Case Akimichi Imamura 1 , Shunji Muraoka 2 1Department of Gastroenterology, Sapporo Kosei Hospital 2Department of Pathology, Sapporo Kosei Hospital Keyword: 感染性大腸炎 , 腸管出血性大腸菌 , EHEC O157:H7 , 縦走潰瘍 , 経過観察 pp.1123-1128
Published Date 1997/7/25
DOI https://doi.org/10.11477/mf.1403104983
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 A 48-year-old female had visited our hospital on Aug. 9, 1996, because of abdominal pain and diarrhea with slight fever from the previous day. She was admitted during the night on the same day because the pain increased and bloody stool subsequently developed. Using methods of RPLA and PCR, stool test was positive for enterohemorrhagic escherichia coli O 157: H7. Radiographic picture on the 5th day after onset showed thumbprinting, irregular margin of the lumen and coarse mucosa in the transverse and descending colon. Decrease in distensibility and thickened mucosal folds in the ascending colon and cecum were also present. The findings closely resembled ischemic colitis. Colonoscopy also revealed markedly edematous and hyperemic mucosa with white coating and hemorrhages in the right and descending colon although the findings in the sigmoid colon and rectum were slight. Radiographic picture on the 21st day after onset showed longitudinal ulcer scars in the transverse colon. Colonoscopy revealed longitudinal ulcer scars and mucosal erythema in the transverse and descending colon. It was suspected that the formation of the longitudinal ulcer scars was caused by ischemia. The pathogenetic mechanism of ischemia is unknown at present.

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