紧急结肠切除术治疗一名接受韦多利珠单抗治疗的溃疡性结肠炎患者的直肠大出血。

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL
Archive of clinical cases Pub Date : 2023-09-26 eCollection Date: 2023-01-01 DOI:10.22551/2023.40.1003.10259
Irina Ciortescu, Roxana Nemteanu, Liliana Gheorghe, Corina Hincu, Liliana Fortu, Oreste Chiriac, Andreea Clim, Alina Plesa
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引用次数: 0

摘要

溃疡性结肠炎(UC)是一种慢性炎症性疾病,有复发-缓解过程。该病例提出了一些关于UC患者短期和长期管理的有效问题,以及是否可以推迟甚至预防结果(结肠切除术)。直肠出血是UC患者的主要症状,它发生在所有活动性疾病患者中。直肠大出血是UC的一种罕见但严重的并发症,占入院人数的0.1-1.4%。然而,值得注意的是,伴有血液动力学不稳定的急性显著下消化道出血的情况很少发生。结肠切除率似乎受到生物治疗的积极影响。然而,难治性疾病仍然是手术的主要原因,这表明迫切需要新的治疗方法。在这里,我们介绍了一名年轻男性患者的病例,他出现了直肠大出血,并接受了紧急结肠切除术和回肠造口术,同时在韦多利珠单抗治疗的第10周出现了临床和生物学缓解(钙卫蛋白水平正常)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Emergency colectomy for massive rectal bleeding in a patient with well-controlled ulcerative colitis receiving Vedolizumab.

Emergency colectomy for massive rectal bleeding in a patient with well-controlled ulcerative colitis receiving Vedolizumab.

Emergency colectomy for massive rectal bleeding in a patient with well-controlled ulcerative colitis receiving Vedolizumab.

Emergency colectomy for massive rectal bleeding in a patient with well-controlled ulcerative colitis receiving Vedolizumab.

Ulcerative colitis (UC) is a chronic inflammatory condition, with a relapsing-remitting course. The case presented poses some valid questions regarding short-term and long-term management of patients with UC, and if the outcome (colectomy) could have been delayed or even prevented. Rectal bleeding is a cardinal symptom in patients with UC and it occurs among all patients during active disease. Massive rectal bleeding is an uncommon, but serious, complication of UC accounting for 0.1-1.4% of admissions. It is, nonetheless, noteworthy that instances of acute significant lower gastrointestinal bleeding accompanied by hemodynamic instability are infrequent. The rate of colectomy appears to be positively impacted by biological treatment. However, a refractory condition is still the primary reason for surgery, indicating a pressing need for new treatment approaches. Here we present the case of a young male patient who developed massive rectal bleeding and underwent emergent colectomy with ileostomy while having clinical and biological remission (normal calprotectin levels) at week 10 of Vedolizumab treatment.

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