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Cytomegalovirus colitis induced segmental colonic hypoganglionosis in an immunocompetent patient: A case report

World Journal of Clinical Cases 2021年第20期9卷 5631-5636页

作者： Ban Seok Kim Seon-Young Park Dong Hyun Kim Nah Ihm Kim Jae Hyun Yoon Jae Kyun Ju Chang Hwan Park Hyun Soo Kim Sung Kyu Choi Department of Gastroenterology Chonnam National University HospitalGwangju 501-757South Korea Department of Pathology Chonnam National University HospitalGwangju 501-757South Korea Department of Surgery Chonnam University HospitalGwangju 501-757South Korea

BACKGROUND Cytomegalovirus(CMV)colitis is usually seen in immunocompromised patients with risk factors such as human immunodeficiency virus infection,solid organ transplant,inflammatory bowel disease,or malignancy.Therefore,many clinicians usually do not consider the possibility of CMV colitis in immunocompetent patients.We reported a rare case of segmental colonic hypoganglionosis associated with CMV colitis in an immunocompetent patient.CASE SUMMARY A 48-year-old woman with no underlying disease was admitted to our hospital for severe abdominal pain and constipation.Computed tomography of the abdomen showed diffuse dilatation of the small intestine and the entire colon.Initial sigmoidoscopic findings and result of polymerase chain reaction(PCR)for CMV revealed the compatible findings of CMV colitis,the patient was treated with intravenous ganciclovir.After treatment,sigmoidoscopic findings and CMV PCR results improved.However the patient continued to suffered from constipation.Eight months after the initial admission,patient visited the emergency department with severe abdominal pain and imaging revealed aggravation of fecal impaction and bowel dilatation.We performed subtotal colectomy to control patient’s symptom.Histological examination of the resected specimen showed significantly reduced number of mature ganglion cells in the sigmoid colon compared to that in the proximal colon.CONCLUSION Our case demonstrates that CMV colitis can develop even in patients with no other underlying disease,and that CMV colitis can be one of the causes for developing colonic hypoganglionosis.

关键词： Colonic pseudo-obstruction Colitis Cytomegalovirus Ganglia Case report

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