Abstract

TAMAYO MENESES, Luis  and  TRUJILLO MORALES, Carlos. Colitis ulcerosa inespecífica como causa de hemorragia digestiva baja: caso pediátrico a propósito de diagnóstico diferencial y manejo. Cuad. - Hosp. Clín. [online]. 2007, vol.52, n.2, pp.66-70. ISSN 1562-6776.

We describe the case of a 2 years and 4 months old girl who was admitted to the hospital for severe bleeding from the rectum after dysentery. Colonoscopy made three hours after the bleeding showed ulcers throughout the colon and the histopathologic exam described an active phase of chronic ulcerative colitis. The treatment is only diet, probiotics and ceftriaxone and the child's state improves. Two control colonoscopies show an unspecifi c rectosigmoiditis with a clear remission of the ulcers. Statistics of ulcerative colitis (CU) recorded in the Instituto Gastroenterológico Boliviano Japonés of La Paz, where all the endoscopic studies of the Children's Hospital are carried out, shows that the present case corresponds to the youngest girl ever reported until now, even though in the international literature, CU is described in babies of only months of age (2). This fact together with the remission of the infl ammatory intestinal disease (EII) without use of CU specifi c drugs, make it necessary to think of differential diagnoses with other diseases with colon ulcers that cause bleedings of the lower gastrointestinal tract. The above together with the endoscopic and histopathologic fi ndings that initially suggested a CU as part of the EII, the progressive remission with only dietetic measures, has drawn the fi nal diagnose of an unspecific ulcerative colitis that needs differential diagnosis due to its evolution and the important bleeding that it caused. For these reasons, the author considers this publication justified.

Keywords : Bleeding of the lower gastrointestinal tract; rectal bleeding; hematoquecia; unspecific ulcerative colitis; colonoscopy; inflammatory bowel disease.