Korean J Gastroenterol.  2019 Aug;74(2):115-118. 10.4166/kjg.2019.74.2.115.

Ischemic Colitis Associated with Rhabdomyolysis and Heat Stroke after an Intense Exercise in Young Adult

Affiliations
  • 1Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea.
  • 2Department of Emergent Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea.
  • 3Department of Radiology, Wonkwang University Sanbon Hospital, Gunpo, Korea.
  • 4Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea.
  • 5Division of Sports Science, Wonkwang University, Iksan, Korea.
  • 6Wonkwang Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan, Korea. medcsc@wonkwang.ac.kr
  • 7Good Breath Clinic, Gunpo, Korea.

Abstract

Ischemic colitis primarily affects the elderly with underlying disease, but it rarely occurs in young adults with risk factors, such as coagulopathy or vascular disorder. Moreover, it is extremely rare in the very young without risk factors. This paper presents a patient with ischemic colitis associated with heat stroke and rhabdomyolysis after intense exercise under high-temperature conditions. A 20-year-old man presented with mental deterioration after a vigorous soccer game for more than 30 minutes in sweltering weather. He also presented with hematochezia with abdominal pain. The laboratory tests revealed the following: AST 515 U/L, ALT 269 U/L, creatine kinase 23,181 U/L, BUN 29.1 mg/dL, creatinine 1.55 mg/dL, and red blood cell >50/high-power field in urine analysis. Sigmoidoscopy showed ischemic changes at the rectum and rectosigmoid junction. A diagnosis of ischemic colitis and rhabdomyolysis was made, and the patient recovered after conservative and fluid therapy. This case showed that a diagnosis of ischemic colitis should be considered in patients who present with abdominal pain and bloody diarrhea after intense exercise, and appropriate treatment should be initiated immediately.

Keyword

Colitis, ischemic; Exercise; Rhabdomyolysis; Young adult
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