Ge JK, Tian HB, Zou HB, He LY. Essential thrombocythemia presenting as localized hemorrhage and mucosal necrosis of transverse colon: A case report. World J Gastrointest Surg 2026; 18(9): 122761 [DOI: 10.4240/wjgs.122761]
Corresponding Author of This Article
Le-Ya He, MD, Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430000, Hubei Province, China. heleya@tjh.tjmu.edu.cn
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Gastroenterology & Hepatology
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case-report
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Ge JK, Tian HB, Zou HB, He LY. Essential thrombocythemia presenting as localized hemorrhage and mucosal necrosis of transverse colon: A case report. World J Gastrointest Surg 2026; 18(9): 122761 [DOI: 10.4240/wjgs.122761]
World J Gastrointest Surg. Sep 27, 2026; 18(9): 122761 Published online Sep 27, 2026. doi: 10.4240/wjgs.122761
Essential thrombocythemia presenting as localized hemorrhage and mucosal necrosis of transverse colon: A case report
Ji-Kui Ge, Hong-Bo Tian, Hong-Bo Zou, Le-Ya He
Ji-Kui Ge, Department of General Surgery, Daye People’s Hospital, Hubei Polytechnic University, Huangshi 435100, Hubei Province, China
Hong-Bo Tian, Department of General Surgery and Anorectal Surgery, Xianfeng County Traditional Chinese Medicine Hospital, Enshi 445000, Hubei Province, China
Hong-Bo Zou, Department of Gastrointestinal Surgery, Deyang People’s Hospital, Deyang 618000, Sichuan Province, China
Le-Ya He, Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
Author contributions: Ge JK followed up the patient and wrote the manuscript; Tian HB and Zou HB contributed to the critical review of the manuscript; He LY diagnosed and treated the patient and organized the clinical data; and all authors have read and approved the final version of the manuscript.
AI contribution statement: AI tools (specifically Dou Bao) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Informed consent statement: Informed written consent was obtained from the patient for publication of this anonymized case report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Le-Ya He, MD, Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430000, Hubei Province, China. heleya@tjh.tjmu.edu.cn
Received: April 30, 2026 Revised: June 17, 2026 Accepted: July 9, 2026 Published online: September 27, 2026 Processing time: 137 Days and 9.6 Hours
Abstract
BACKGROUND
Most patients with essential thrombocythemia (ET) are asymptomatic. Symptomatic patients predominantly present with elevated platelet counts, microcirculatory disturbances, and thrombosis. Cases manifesting with gastrointestinal bleeding, even if complicated by colonic congestion, edema, and mucosal necrosis, are extremely rare. Patients with gastrointestinal bleeding or peritonitis usually require surgery. This report highlights timely surgery in managing ET-related acute abdomen.
CASE SUMMARY
A 60-year-old female presented with abdominal pain and hematochezia, accompanied by peritoneal irritation signs, leukocytosis, thrombocytosis, and transverse colon hemorrhage/edema/congestion. With progressive aggravation of peritonitis and no obvious reduction in inflammatory markers were observed after conservative treatment. Contrast-enhanced computed tomography showed transverse colon edema, distension, segmental colonic wall thickening, and luminal stenosis. Emergency transverse colectomy was performed; pathology revealed vascular abnormalities and mucosal necrosis. Peritonitis improved with a sustained decline in inflammatory markers after operation. ET was confirmed by JAK2 V617F mutation, and the patient achieved a good recovery following hydroxyurea treatment and follow-up.
CONCLUSION
For patients with gastrointestinal bleeding and peritonitis, timely identification and surgical intervention are critical for definitive treatment of ET.
Core Tip: Most patients with essential thrombocythemia (ET) are asymptomatic, and colonic hemorrhage, edema and mucosal necrosis are extremely rare. We report a 60-year-old female presenting with abdominal pain, hematochezia and peritonitis, who underwent emergency colectomy. After operation, peritonitis improved with a sustained decline in inflammatory markers. ET was confirmed by JAK2 V617F mutation, and the patient had a good recovery after hydroxyurea treatment and follow-up. Timely surgical intervention is critical in treatment of ET with acute abdomen.
