Colonic Ischemic Stricture Presenting as a Late Complication of the Hemolytic Uremic Syndrome

Colonic stricture secondary to hemolytic uremic syndrome caused by Escherichia coli O-157

“…Only 16 cases of this disease have been reported in the literature so far [4,5,6,7,8,9,10,11,12,13], including our case. The characteristics of all 16 cases Table 1.…”

“…One case was caused by Shiga toxin, but the type of bacteria was not found [11]. In 1 case, E. coli was observed in the stool, but the serotype was not detected [12]. In only our case, E. coli O-157 was detected.…”

“…In 1 case with descending colonic stricture, stricture was observed at 4 different sites in the descending colon [7]. Only 3 cases described bacteria as the cause of HUS [11,12], including our case. One case was caused by Shiga toxin, but the type of bacteria was not found [11].…”

“…Therefore, the bowel ischemic change is thought to result in colonic stricture. In contrast, five cases presented with bowel symptoms over one year after the onset of HUS [10,11,12,13]. The real mechanism regarding the formation of stricture at that time after HUS is unclear.…”

Gastrointestinal Dysfunction Following Hemolytic Uremic Syndrome

“…Late-onset strictures additionally show scarring and adhesion formation. These late-onset findings, still unclear in etiology, are thought to be a result of continued chronic inflammatory changes in the bowel itself [2,5]. The additional abnormalities of small bowel function found in this patient have not been previously described.…”