A case of gangrenous ischemic colitis with abnormally elevated serum level of CEA

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  • 血清CEAが異常高値を呈した壊死型虚血性大腸炎の1例
  • ショウレイ ケッセイ CEA ガ イジョウ タカネ オ テイシタ エシガタキョケツセイ ダイチョウエン ノ 1レイ

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Abstract

An 80-year-old woman was transported to our hospital due to lower abdominal pain and vomit, and was found on physical examination to have abdominal distension. Abdominal computed tomography (CT) scan showed a markedly dilated colon and ischemic change of the colon wall. Blood analysis showed metabolic acidosis and serum CEA was elevated to 559.1 ng/ml. Suspecting necrosis of the colon, we conducted a laparotomy. The operative finding showed necrotic change of the ascending to descending colon, and we performed a subtotal colectomy and ileostomy.<BR>Pathological findings showed gangrenous ischemic colitis. In immunohistochemical analysis, the pattern of CEA indicated inflammatory bowel disease. Serum CEA level normalized to 2.4 ng/ml on the 16th hospital day and the patient was discharged on the 34th hospital day. The mechanism of elevated serum CEA is responsible for dysfunction of the drain system for CEA in the mucosal epithelium. It is necessary to consider that ischemic colitis can cause elevation of serum CEA, especially in aged patients with acute abdomen.

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