Browse > Article

A Case of a Cytomegalovirus Colitis Related Rectal Stricture Treated by Endoscopic Balloon Dilation  

Park, Kwon-Oh (Department of Internal Medicine, Hallym University College of Medicine)
Kim, Kyung-Ho (Department of Internal Medicine, Hallym University College of Medicine)
Park, Jong-Won (Department of Internal Medicine, Hallym University College of Medicine)
Lee, Sang-Ho (Department of Internal Medicine, Hallym University College of Medicine)
Jo, Hyun-Jung (Department of Internal Medicine, Hallym University College of Medicine)
Chun, Seung-Yun (Department of Internal Medicine, Hallym University College of Medicine)
Park, Hye-Won (Department of Internal Medicine, Hallym University College of Medicine)
Kim, Hak-Yang (Department of Internal Medicine, Hallym University College of Medicine)
Publication Information
Clinical Endoscopy / v.41, no.4, 2010 , pp. 240-244 More about this Journal
Abstract
Cytomegalovirus (CMV) colitis is a common opportunistic infection in immunocompromised patients. Affected individuals present with abdominal pain, diarrhea, or hematochezia. Complications of CMV colitis can include massive bleeding, toxic megacolon, bowel perforation and, rarely, colon stricture. A 69-year-old woman who had no specific past history was admitted to the orthopedic department for pelvic bone fracture with right iliac artery rupture caused by a traffic accident. She was successfully managed with emergency transarterial coil embolization. After 2 weeks, she developed hematochezia and recurrent abdominal pain. Colonoscopy showed a huge, deep ulcer in the rectosigmoid colon. Biopsy and immunohistochemical staining revealed giant cells with intracellular inclusion bodies that were positive for CMV antigen. She received antiviral treatment after which her symptoms improved. On follow-up colonoscopy 3 months later, we found a tight luminal narrowing in the rectum. We did a repeat endoscopic balloon dilation in this patient and she experienced improvement.
Keywords
Cytomegalovirus; Colitis; Stricture; Balloon dilation;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
연도 인용수 순위
1 Mohammed AA, Benmousa A, Almeghaiseeb I, Alkarawi M. Gastric outlet obstruction. Hepatogastroenterology 2007;54:2415-2420.
2 Kume K, Yoshikawa I. Rectal stenosis caused by cytomegalovirus colitis. Endoscopy 2009;41(suppl 2):E197.
3 Ng FH, Chau TN, Cheung TC, et al. Cytomegalovirus colitis in individuals without apparent cause of immunodeficiency. Dig Dis Sci 1999;44:945-952.   DOI   ScienceOn
4 Diaz-Gonzalez VM, Altemose GT, Ogrek C, et al. Cytomegalovirus infection presenting as an apple-core lesion of the colon. J Heart Lung transplant 1997;16:1171-1175.
5 Goodman ZD, Boitnott JK, Yardley JH. Perforation of the colon associated cytomegalovirus infection. Dig Dis Sci 1979;24:376-380.   DOI   ScienceOn
6 Galiatsatos P, Shrier I, Lamoureux E, Szilagyi A. Meta-analysis of outcome of cytomegalovirus colitis in immunocompetent hosts. Dig Dis Sci 2005;50:609-616.   DOI   ScienceOn
7 Solt J, Hertelendy A, Szilagy K. Long-term results of balloon catheter dilatation of lower gastrointestinal tract stenoses. Dis Colon Rectum 2004;47:1499-1505.   DOI   ScienceOn
8 Lee JY, Lee SH, Kim SP, et al. A case of benign colonic stricture treated by therapeutic balloon dilatation in ulcerative colitis. Korean J Gastrointest Endosc 2008;37:380-383.
9 Goodgame RW. Gastrointestinal cytomegalovirus disease. Ann Intern Med 1993;119:924-935.   DOI   ScienceOn
10 Patra S, Samal SC, Chacko A, Mathan VI, Mathan MM. Cytomegalovirus infection of the human gastrointestinal tract. J Gastroenterol Hepatol 1999;14:973-976.   DOI   ScienceOn
11 Lee SY. Cytomegalovirus colitis in an immunocompetent adult. Korean J Gastroenterol 2007;50:75-77.
12 Mariorana A, Baccarini P, Foroni M, Bellini N, Giusti F. Human cytomegalovirus infection of the gastrointestinal tract in apparently immunocompetent patients. Hum Pathol 2003;34:1331-1336.   DOI   ScienceOn
13 Cheung AN, Ng IO. Cytomegalovirus infection of the gastrointestinal tract in non-AIDS patients. Am J Gastroenterol 1993;88:1882-1886.
14 Camprodon RA, Jacob S, Malkawi A, Al-Ghnaniem R. CMV colitis presenting as acute abdomen requires early diagnosis and treatment to avoid mortality. Acta Chir Belg 2007;107:378-381.
15 Reyes C, Pereira S, Warden MJ, Sills J. Cytomegalovirus enteritis in a premature infant. J Pediatr Surg 1997;32:1545-1547.   DOI   ScienceOn
16 Lee ES, Jang MK, Park SY, et al. A case of iatrogenic tension pneumoperitoneum following colonoscopy in a patient with cytomegalovirus colitis. Korean J Gastroenterol 2006;47:312-315.