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KMID : 0931320160160030165
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대한상부위장관.헬리코박터학회지
2016 Volume.16 No. 3 p.165 ~ p.168
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Severe Ischemic Colitis from Gastric Ulcer Bleeding-Induced Shock in Patient with End Stage Renal Disease Receiving Hemodialysis
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Yoon Byung-Wook
Park Jong-Seol
Woo Yong-Sik
Jang Jae-Hoon
Lee Seok-Youn
Hong Nu-Rhee
Kim Yong-Sung
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Abstract
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Upper gastrointestinal bleeding is a common condition and has various clinical courses and prognosis. End stage renal disease (ESRD) patients receiving hemodialysis have a high risk of vascular complications and increased risk of ischemic colitis. A 59-year-old male patient with ESRD receiving hemodialysis visited due to hematemesis. After admission, he showed recurrent hematemesis and hypovolemic shock. Upper esophagogastroduodenoscopy revealed gastric ulcer bleeding and endoscopic hemostasis was successfully performed. Blood transfusion and norepinephrine was administered for hypovolemic shock during initial 3 days. Ten days later, he exhibited hematochezia. Sigmoidoscopy revealed necrotic ischemic colitis in sigmoid colon and segmental colectomy was performed. However, recurrent leakage and ischemia were developed in colon as well as small bowel, and he finally died after 55 hospital days in spite of additional operations. Here, we report a case of peptic ulcer bleeding in patient with ESRD who suffered a severe form of ischemic colitis with transmural necrosis.
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KEYWORD
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Stomach ulcer, Colitis, ischemic, Necrosis, Kidney failure, chronic
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