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Korean J Gastroenterol  <  Volume 74(2); 2019 <  Articles

Korean J Gastroenterol 2019; 74(2): 115-118  https://doi.org/10.4166/kjg.2019.74.2.115
Ischemic Colitis Associated with Rhabdomyolysis and Heat Stroke after an Intense Exercise in Young Adult
Serin Cha1, Bo Sung Kwon2, Nurhee Hong3, Jong Seol Park4, Sin Kyu Byun5, Suck Chei Choi6 and Yong Sung Kim6,7
Departments of Internal Medicine1, Emergent Medicine2 and Radiology3, Wonkwang University Sanbon Hospital, Gunpo; Department of Internal Medicine, SMG-SNU Boramae Medical Center4, Seoul; Division of Sports Science, Wonkwang University5; Wonkwang Digestive Disease Research Institute, Wonkwang University School of Medicine6, Iksan; Good Breath Clinic7, Gunpo, Korea
Correspondence to: Suck Chei Choi, Wonkwang Digestive Disease Research Institute, Wonkwang University School of Medicine, 460 Iksan-daero, Iksan 54538, Korea. Tel: +82-63-859-2670, Fax: +82-63-855-2025, E-mail: medcsc@wonkwang.ac.kr, ORCID: https://orcid.org/0000-0003-1338-3306

Financial support: This work supported by Wonkwang University 2019 (SCC).
Received: April 3, 2019; Revised: April 30, 2019; Accepted: May 7, 2019; Published online: August 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Ischemic colitis primarily affects the elderly with underlying disease, but it rarely occurs in young adults with risk factors, such as coagulopathy or vascular disorder. Moreover, it is extremely rare in the very young without risk factors. This paper presents a patient with ischemic colitis associated with heat stroke and rhabdomyolysis after intense exercise under high-temperature conditions. A 20-year-old man presented with mental deterioration after a vigorous soccer game for more than 30 minutes in sweltering weather. He also presented with hematochezia with abdominal pain. The laboratory tests revealed the following: AST 515 U/L, ALT 269 U/L, creatine kinase 23,181 U/L, BUN 29.1 mg/dL, creatinine 1.55 mg/dL, and red blood cell >50/high-power field in urine analysis. Sigmoidoscopy showed ischemic changes at the rectum and rectosigmoid junction. A diagnosis of ischemic colitis and rhabdomyolysis was made, and the patient recovered after conservative and fluid therapy. This case showed that a diagnosis of ischemic colitis should be considered in patients who present with abdominal pain and bloody diarrhea after intense exercise, and appropriate treatment should be initiated immediately.
Keywords: Colitis, ischemic; Exercise; Rhabdomyolysis; Young adult


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