TY - JOUR
T1 - Ulcerative colitis-related postoperative enteritis treated with anti-tumor necrosis factor therapy
T2 - two case reports and a literature review
AU - Shimoda, Fumiko
AU - Kuroha, Masatake
AU - Chiba, Hirofumi
AU - Abe, Izuru
AU - Yano, Kota
AU - Inomata, Yushi
AU - Takahashi, Takahiro
AU - Shimoyama, Yusuke
AU - Moroi, Rintaro
AU - Shiga, Hisashi
AU - Kakuta, Yoichi
AU - Fujishima, Fumiyoshi
AU - Masamune, Atsushi
N1 - Publisher Copyright:
© 2021, Japanese Society of Gastroenterology.
PY - 2021/10
Y1 - 2021/10
N2 - Several case reports have described severe postoperative enteritis shortly after total colectomy for ulcerative colitis. The very low incidence of this condition makes diagnosis and treatment difficult, and the appropriate treatment strategy is unclear. We report two cases of enteritis after surgery for ulcerative colitis, which were treated with anti-tumor necrosis factor-α therapy. Case 1 involved a 22-year-old man with symptoms, such as nausea 40 days after total colectomy. Gastrointestinal endoscopy revealed patchy obliteration of the vascular pattern, erosions in the duodenum, and superficial ulcers in the small intestine. His symptoms and endoscopic findings immediately improved upon administration of infliximab; clinical remission lasted 5 years with continuous administration. Case 2 involved a 64-year-old man, who had a large amount of watery diarrhea from ileostomy that increased 5 days after total colectomy; gastrointestinal endoscopy revealed extensive ulcers in the small intestine. Symptoms and endoscopic findings improved with prednisolone, but relapsed with tapering of the corticosteroid. Administration of adalimumab resulted in marked improvement of enteritis. However, the small intestine developed a pinhole stricture, and partial resection of the small intestine was performed. Our experience with two cases indicates that anti-tumor necrosis factor-α therapy may play an important role in ulcerative colitis-related postoperative enteritis.
AB - Several case reports have described severe postoperative enteritis shortly after total colectomy for ulcerative colitis. The very low incidence of this condition makes diagnosis and treatment difficult, and the appropriate treatment strategy is unclear. We report two cases of enteritis after surgery for ulcerative colitis, which were treated with anti-tumor necrosis factor-α therapy. Case 1 involved a 22-year-old man with symptoms, such as nausea 40 days after total colectomy. Gastrointestinal endoscopy revealed patchy obliteration of the vascular pattern, erosions in the duodenum, and superficial ulcers in the small intestine. His symptoms and endoscopic findings immediately improved upon administration of infliximab; clinical remission lasted 5 years with continuous administration. Case 2 involved a 64-year-old man, who had a large amount of watery diarrhea from ileostomy that increased 5 days after total colectomy; gastrointestinal endoscopy revealed extensive ulcers in the small intestine. Symptoms and endoscopic findings improved with prednisolone, but relapsed with tapering of the corticosteroid. Administration of adalimumab resulted in marked improvement of enteritis. However, the small intestine developed a pinhole stricture, and partial resection of the small intestine was performed. Our experience with two cases indicates that anti-tumor necrosis factor-α therapy may play an important role in ulcerative colitis-related postoperative enteritis.
KW - Adalimumab
KW - Colectomy
KW - Gastroduodenitis
KW - Infliximab
KW - Stricture
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U2 - 10.1007/s12328-021-01485-5
DO - 10.1007/s12328-021-01485-5
M3 - Article
C2 - 34302278
AN - SCOPUS:85111162523
SN - 1865-7257
VL - 14
SP - 1396
EP - 1403
JO - Clinical Journal of Gastroenterology
JF - Clinical Journal of Gastroenterology
IS - 5
ER -