Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2019; 7(16): 2360-2366
Published online Aug 26, 2019. doi: 10.12998/wjcc.v7.i16.2360
Ulcerative colitis complicated with colonic necrosis, septic shock and venous thromboembolism: A case report
Ming-Yu Zhu, Li-Qun Sun
Ming-Yu Zhu, Li-Qun Sun, Critical Care Unit, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
Author contributions: Zhu MY drafted the manuscript; Sun LQ revised the article critically; All authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
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).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Li-Qun Sun, MD, Adjunct Professor, Critical Care Unit, the Second Affiliated Hospital of Nanjing Medical University, No. 121 Jiangjiayuan Road, Gulou District, Nanjing 210011, Jiangsu Province, China. njuslq@163.com
Telephone: +86-15005168556
Received: May 9, 2019
Peer-review started: May 10, 2019
First decision: June 12, 2019
Revised: June 19, 2019
Accepted: July 20, 2019
Article in press: July 20, 2019
Published online: August 26, 2019
Abstract
BACKGROUND

Severe total colonic necrosis, septic shock and venous thromboembolism secondary to ulcerative colitis (UC) are rare and life-threatening. No such severe complications have been reported in the literature.

CASE SUMMARY

We report a 36-year-old woman who developed total colonic necrosis and septic shock secondary to UC. The patient was treated with emergency surgery because computed tomography showed suspicious perforations. Persistent massive ascites occurred after operation and computed tomography angiography demonstrated portal vein, mesenteric vein and splenic vein thrombosis. The patient was discharged from hospital after active treatment.

CONCLUSION

Clinicians should pay attention to venous thrombosis, colonic necrosis and septic shock in UC patients. Close observation of surgical indications and timely surgical intervention are the key to reduce mortality and complications in UC.

Keywords: Ulcerative colitis, Total colonic necrosis, Venous thromboembolism, Sepsis, Septic shock, Case report

Core tip: Severe total colonic necrosis, septic shock and venous thromboembolism are rare but life-threatening complications of ulcerative colitis. Possibility of colonic necrosis in ulcerative colitis should be considered and close observation of surgical indications and timely surgical intervention are the key to reduce mortality and complications in ulcerative colitis.