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Korean J Gastroenterol  <  Volume 75(4); 2020 <  Articles

Korean J Gastroenterol 2020; 75(4): 216-219  https://doi.org/10.4166/kjg.2020.75.4.216
Ischemic Colitis Associated with Low-volume Oral Sulfate Solution for Bowel Preparation
Jung Wha Chung, Jung Min Lee, Young Woo Sohn, Weon Cheol Han1 and Kichul Yoon
Departments of Internal Medicine and Pathology1, Wonkwang University Sanbon Hospital, Gunpo, Korea
Correspondence to: Kichul Yoon, Department of Internal Medicine, Wonkwang University Sanbon Hospital, 321 Sanbon-ro, Gunpo 15865, Korea. Tel: +82-31-390-2204, Fax: +82-31-390-2592, E-mail: paradise_city@hanmail.net, ORCID https://orcid.org/0000-0003-1392-2808
Received: December 25, 2019; Revised: February 10, 2020; Accepted: February 17, 2020; Published online: April 25, 2020.
© 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 resulting from bowel preparation for colonoscopy is extremely rare, with only a small number of cases with polyethylene glycol having been reported. Here, we present a patient with ischemic colitis after administration of a low-volume oral sulfate solution (OSS). A 49-year-old female without any significant medical history experienced abdominal pain, vomiting, and hematochezia after ingestion of OSS. She complained of severe abdominal pain during colonoscopy, and diffuse edema, hyperemia, friability, and shallow erosions were present on the transverse, descending, and sigmoid colons. A mucosal biopsy revealed mixed lymphoid inflammatory cell infiltration with de-epithelialization, whereas an abdominal CT scan showed submucosal edema on the transverse colon. A diagnosis of ischemic colitis was made. The patient recovered with fluid and antibiotic therapy without significant sequelae. Although OSS is a clinically validated and generally safe bowel preparation agent, ischemic colitis is a rare complication that should be considered.
Keywords: Colitis, ischemic; Bowel preparation; Colonoscopy


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