腸間膜脂肪織炎様の内視鏡所見を呈するに至った虚血性腸炎の1例

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  • A Case Report of Ischemic Colitis Followed by Mesenteric Panniculitis

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A case of male of ischemic colitis followed by mesenteric panniculitis is reported. The patient complained of hematochezia and lower abdominal pain. Laboratory findings on admission were increased WBC and positive CRP. Colonoscopy showed mucosal edema, and multiple erosions and ulcers in sigmoid colon. The patient was diagnosed as ischemic colitis and we treated him conservatively with intravenous drip infusion of antibiotics. His symptoms were promptly improved. After he started oral intakes, he complained of abdominal pain, and laboratory findings revealed further increased WBC and CRP. Abdominal roentgenogram showed a“stepladder”sign as ileus. Colonoscopy showed mucosal edema and narrowing without erosions and ulcerations in the sigmoid colon. Contrast-enhanced CT image demonstrated wall-thickning of the sigmoid colon surrounded by high density which suggests inflammation in soft tissues around sigmoid colon. Under the diagnosis of ischemic colitis followed with mesenteric panniculitis, he was treated with total parenteral nutrition and prednisolone. Clinical symptoms were improved and laboratory findings turned to be normal.

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