CASE REPORTS   

Chirurgia 2014 February;27(1):15-8

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: Italian

A case of iatrogenic benign ulcer of the right colon

Testi W. ¹, Varrone F. ², Baldoni G. ², Scipioni F. ³, Savelli V. ⁴, Mazzei M. A. ², Ludovisi M. G. ², Colasanto G. ¹, Borgogni V. ¹

¹ Azienda Ospedaliera Universitaria Senese, Siena (Italy); ² Policlinico Universitario, Siena (Italy); ³ Policlinico Santa Maria alle Scotte, Siena (Italy); ⁴ Dipartimento di Chirurgia, Unità di Chirurgia Generale II Policlinico Le Scotte, Università di SienaUniversity, Siena, Italy

We report a rare case of benign ulcer of the right colon iatrogenic characterized by a difficult management. We present the case of a woman admitted for hematochezia and abdominal pain to the right-angled and hyperpyrexia, anticoagulant therapy for aortic and mitral valve replacement. Physical examination showed a painful swelling of the abdomen with peritoneal, ultrasound examination showed a thickening of the entire right colon confirmed by CT. Broad-spectrum antibiotic therapy and parenteral nutrition were practiced, which allowed a complete remission of the clinic, in addition to performing colonoscopy, which showed a vegetating lesion of the transverse colon. The patient was discharged waiting for the pathology report of endoscopy, but immediately fell to massive hematochezia, for which a right hemicolectomy was practiced in an emergency. This case presented with a difficult diagnostic definition. Initially, both the clinical examination or CT suggested a framework inflammation, while colonoscopy addressed to a pathology eteroplastica. The histology was nullifying the definition of iatrogenic benign ulcer. Despite advances in radiology, diagnosis of certain diseases, which are particularly unusual, still remains impossible. Our case is an example of diagnostic and therapeutic difficulties associated with this type of uncertainty, resolved by histological examination.