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Peer-reviewedCC BYSurgical case reports

Urgent Colectomy for Colonic Necrosis Following Shiga Toxin-Producing Escherichia coli O157 Infection in an Adult.

  • Kenta Baba1
  • Tatsuaki Sumiyoshi2
  • Takeshi Kobayashi3
  • Yoshifumi Kondo4
  • Sho Tazuma2
  • Keisuke Okano5
  • Takeshi Muto6
  • Naokuni Tatsumoto5
  • Shinya Takahashi2
6 affiliations
  1. 1Department of Surgery, NHO Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan.
  2. 2Department of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Hiroshima, Japan.
  3. 3Department of Surgery and Pediatric Surgery, Hiroshima City Funairi Citizens Hospital, Hiroshima, Hiroshima, Japan.
  4. 4Department of Surgery, JA Hiroshima General Hospital, Hatsukaichi, Hiroshima, Japan.
  5. 5Department of Surgery, Miyoshi Central Hospital, Hiroshima, Miyoshi, Japan.
  6. 6Muto Internal Medicine, Surgery and Gastroenterology Clinic, Hiroshima, Hiroshima, Japan.
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Abstract

Introduction

Shiga toxin-producing Escherichia coli (STEC) O157 infection is usually treated conservatively; surgery is rarely required and mostly reserved for children with hemolytic uremic syndrome (HUS). We report a case of STEC O157 requiring urgent surgery in an adult without HUS.Case presentation

A 73-year-old woman presented with abdominal pain and diarrhea. Abdominal CT showed diffuse wall thickening in the ascending and transverse colon. Infectious enteritis and acute exacerbation of chronic renal failure were diagnosed, and antibiotics and continuous hemodiafiltration were initiated. On day 5 of hospitalization, necrotic ischemic colitis was suspected owing to bloody diarrhea and contrast-enhanced CT findings of wall thinning of the ascending and transverse colon. On laparotomy, the ascending colon and proximal transverse colon were necrotic, and urgent surgery (right hemicolectomy) was performed. Postoperatively, the stool sample provided at admission was found to be positive for Escherichia coli O157 and Shiga toxin.Conclusions

The postoperative course was uneventful, and dialysis was discontinued. This case highlights that STEC O157 infection can rapidly progress to life-threatening colonic necrosis in adults without HUS, requiring timely surgical intervention.

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Cite

BibTeXRIS
BibTeX
@article{baba2026urgent,
  title = {{Urgent Colectomy for Colonic Necrosis Following Shiga Toxin-Producing Escherichia coli O157 Infection in an Adult.}},
  author = {Kenta Baba and Tatsuaki Sumiyoshi and Takeshi Kobayashi and Yoshifumi Kondo and Sho Tazuma and Keisuke Okano and Takeshi Muto and Naokuni Tatsumoto and Shinya Takahashi},
  journal = {Surgical case reports},
  year = {2026},
  month = oct,
  doi = {10.70352/scrj.cr.26-0457},
  url = {https://europepmc.org/article/MED/42898574},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Urgent Colectomy for Colonic Necrosis Following Shiga Toxin-Producing Escherichia coli O157 Infection in an Adult.
AU  - Kenta Baba
AU  - Tatsuaki Sumiyoshi
AU  - Takeshi Kobayashi
AU  - Yoshifumi Kondo
AU  - Sho Tazuma
AU  - Keisuke Okano
AU  - Takeshi Muto
AU  - Naokuni Tatsumoto
AU  - Shinya Takahashi
PY  - 2026
DA  - 2026/10/16
JO  - Surgical case reports
DO  - 10.70352/scrj.cr.26-0457
UR  - https://europepmc.org/article/MED/42898574
AB  - Introduction  Shiga toxin-producing Escherichia coli (STEC) O157 infection is usually treated conservatively; surgery is rarely required and mostly reserved for children with hemolytic uremic syndrome (HUS). We report a case of STEC O157 requiring urgent surgery in an adult without HUS.Case presentation  A 73-year-old woman presented with abdominal pain and diarrhea. Abdominal CT showed diffuse wall thickening in the ascending and transverse colon. Infectious enteritis and acute exacerbation of chronic renal failure were diagnosed, and antibiotics and continuous hemodiafiltration were initiated. On day 5 of hospitalization, necrotic ischemic colitis was suspected owing to bloody diarrhea and contrast-enhanced CT findings of wall thinning of the ascending and transverse colon. On laparotomy, the ascending colon and proximal transverse colon were necrotic, and urgent surgery (right hemicolectomy) was performed. Postoperatively, the stool sample provided at admission was found to be positive for Escherichia coli O157 and Shiga toxin.Conclusions  The postoperative course was uneventful, and dialysis was discontinued. This case highlights that STEC O157 infection can rapidly progress to life-threatening colonic necrosis in adults without HUS, requiring timely surgical intervention.
SN  - 2198-7793
ER  -