Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
症例
内視鏡前処置のpicosulfateが誘因と考えられた虚血性大腸炎の1例
松岡 愛菜, 堀内 亮郎, 小林 克誠, 池 真実, 飯塚 泰弘, 上山 俊介, 外山 雄三, 間野 真也, 古本 洋平, 那須 啓一, 稲田 健太郎, 佐崎 なほ子, 淺野 徹, 真栄城 剛, 忠願寺 義通, 藤木 和彦
著者情報
キーワード: picosulfate, 虚血性大腸炎
ジャーナル フリー

2014 年 85 巻 1 号 p. 118-119

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A 50-year-old woman with constipation, high blood pressure, and a history of open abdominal surgery for myoma of the uterus was referred to our hospital for colonoscopy because of a positive fecal occult blood test during a medical checkup. The patient was administered 10 ml of picosulfate at 9 PM. Approximately 8 hours later, she developed vomiting, melena, and severe lower abdominal pain. Colonoscopy revealed reddening, edema, longitudinal erosions and easy bleeding in the sigmoid colon. The patient was diagnosed as having ischemic colitis and hospitalized. With conservative treatment, she recovered within 5 days and was discharged. Six weeks later, she underwent a colonoscopy without prior administration of picosulfate, and the findings revealed complete recovery.
Risk factors for ischemic colitis include high intracolonic pressure, rapid peristalsis, constipation, adhesions, postoperative state, and high blood pressure, some of which were present in this patient. Prior administration of a mild laxative instead of picosulfate should be considered for patients with such risk factors.

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© 2014 一般社団法人 日本消化器内視鏡学会 関東支部
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