A Case of Successful Colectomy for Hemorrhagic Colitis with Hemolytic Uremic Syndrome, due to Escherichia Coli O-157 Infection

A 58-year-old female was admitted for lower abdominal pain and bloody diarrhea. Two days after administration, she had frequent bloody diarrhea with aggravation of her renal function (BUN 42. 4mg·dl, Cr 3. 4mg dl). Physical examination revealed severe tenderness, rebound tenderness and slight muscle guarding in theright lateral abdominal region. CT scan showed severe thickness and edema of the wall in the right colon and massive ascites in the lower abdomen. We diagnosed hemorrhagic colitis with acute renal failure, with a risk of panperitonitis. We conducted a wide right hemicolectomy. We performed postoperative extracorporealelimination of endotoxins and continuous hemodiafiltration. A feces culture failed to show growth of Escherichia coli O-157. Blood studies, however, included a positive result for the O-157 antibody. The patient was discharged on postoperativeday 78. This is one of the successful cases of surgical therapy for hemorrhagiccolitis with hemolytic uremic syndrome.