Hematochezia and colitis in a new diagnosis of anorexia nervosa in an 11-year-old boy: a case report
- 1Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, Box 0110, 550 16th St, San Francisco, CA 94143 USA
- 2Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, 550 16th St, Box 0110, San Francisco, CA 94143 USA
Abstract
Background: To our knowledge, this is one of the first case reports describing hematochezia and acute colitis as a consequence of refeeding in the setting of severe malnutrition. The differential diagnosis was broad and included ischemic (for example, possible reperfusion-like injury following refeeding), infectious, and autoimmune/inflammatory (for example, inflammatory bowel disease) etiologies. This presentation is rare, particularly in early adolescents and boys.
Case presentation: This case report describes an 11-year-old boy who intentionally restricted his food intake for six months, resulting in a 17.1-kg weight loss (from 50.9 kg to 33.8 kg), and who presented after 72 h without oral intake. Shortly after initiating enteral nutrition via nasogastric tube, the patient developed significant hematochezia associated with a fever, tachycardia, and a marked elevation in C-reactive protein and fecal calprotectin. A computed tomography of the abdomen was concerning for diffuse ischemic colitis of unclear etiology, leading to a diagnostic laparoscopy, which demonstrated an edematous, acutely inflamed colon with no areas of ischemia.
Conclusions: The present case highlights an unusual gastrointestinal complication of severe malnutrition and the refeeding process.
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BibTeX
@article{ricklefs2026hematochezia,
title = {{Hematochezia and colitis in a new diagnosis of anorexia nervosa in an 11-year-old boy: a case report}},
author = {Colbey Ricklefs and Elizaveta Ignatova and Sara M. Buckelew},
journal = {Journal of Eating Disorders},
year = {2026},
month = aug,
doi = {10.1186/s40337-026-01737-0},
url = {https://doi.org/10.1186/s40337-026-01737-0},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Hematochezia and colitis in a new diagnosis of anorexia nervosa in an 11-year-old boy: a case report
AU - Colbey Ricklefs
AU - Elizaveta Ignatova
AU - Sara M. Buckelew
PY - 2026
DA - 2026/08/10
JO - Journal of Eating Disorders
DO - 10.1186/s40337-026-01737-0
UR - https://doi.org/10.1186/s40337-026-01737-0
AB - Background: To our knowledge, this is one of the first case reports describing hematochezia and acute colitis as a consequence of refeeding in the setting of severe malnutrition. The differential diagnosis was broad and included ischemic (for example, possible reperfusion-like injury following refeeding), infectious, and autoimmune/inflammatory (for example, inflammatory bowel disease) etiologies. This presentation is rare, particularly in early adolescents and boys. Case presentation: This case report describes an 11-year-old boy who intentionally restricted his food intake for six months, resulting in a 17.1-kg weight loss (from 50.9 kg to 33.8 kg), and who presented after 72 h without oral intake. Shortly after initiating enteral nutrition via nasogastric tube, the patient developed significant hematochezia associated with a fever, tachycardia, and a marked elevation in C-reactive protein and fecal calprotectin. A computed tomography of the abdomen was concerning for diffuse ischemic colitis of unclear etiology, leading to a diagnostic laparoscopy, which demonstrated an edematous, acutely inflamed colon with no areas of ischemia. Conclusions: The present case highlights an unusual gastrointestinal complication of severe malnutrition and the refeeding process.
SN - 2050-2974
ER -