Ischemic bowel disease characterized by colorectal mucosal necrosis induced by cardiac arrest

The patient was a 60-year-old male. He developed impaired consciousness after drinking alcohol more than 20 days ago and was found 12 hours later to have an altered level of consciousness with vomiting. The vomit was brown in color. Cardiopulmonary resuscitation (CPR) was performed immediately after calling the emergency number (120) and finding the patient in respiratory and cardiac arrest. After 20 minutes of resuscitation, the patient regained supraventricular rhythm but remained in a deep coma. He was transported to the hospital for treatment and was admitted to the intensive care unit (ICU) after endotracheal intubation and CPR. Initial laboratory tests revealed leukocytosis (WBC 17.02 × 10⁹/L), markedly elevated inflammatory markers (calcitoninogen 38.6 ng/mL, C-reactive protein 138 mg/L), acute kidney injury (serum creatinine 386 μmol/L), hyperkalemia (6.2 mmol/L), and coagulation dysfunction (D-dimer 85 μg/mL). Due to sepsis, acute renal failure, hyperprolactinemia and electrolyte imbalance, the patient was started on bedside continuous renal replacement therapy (CRRT). During hospitalization, the patient developed recurrent bloody stools with gradually increasing frequency and volume. Colonoscopy revealed rectal mucosal detachment and bleeding. His medical history included hypertension and diabetes mellitus.