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Ischemic Colitis Associated with Low-volume Oral Sulfate Solution for Bowel Preparation
Jung Wha Chung1, Jung Min Lee1, Young Woo Sohn1
1Departments of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea.
Summary
Ischemic colitis is a rare complication of bowel preparation for colonoscopy. This case highlights a potential risk associated with oral sulfate solution (OSS) use, emphasizing the need for clinical consideration.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Medical Complications
Background:
- Bowel preparation is essential for colonoscopy.
- Polyethylene glycol (PEG) is a common agent.
- Oral sulfate solution (OSS) is an alternative bowel preparation agent.
Observation:
- A 49-year-old female experienced abdominal pain, vomiting, and hematochezia after OSS ingestion.
- Colonoscopy revealed diffuse edema, hyperemia, friability, and erosions in the transverse, descending, and sigmoid colons.
- Abdominal CT scan showed submucosal edema in the transverse colon.
Findings:
- Mucosal biopsy confirmed mixed lymphoid inflammatory cell infiltration and de-epithelialization.
- Diagnosis of ischemic colitis was established.
- The patient recovered with supportive care.
Implications:
- Ischemic colitis is an extremely rare but potential complication of OSS bowel preparation.
- Clinicians should consider ischemic colitis in patients presenting with relevant symptoms post-OSS.
- While generally safe, vigilance for rare adverse events with OSS is warranted.
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