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JAMA Surgery Clinical Challenge
March 2018

Patient With Ulcerative Colitis and Abdominal Pain

Author Affiliations
  • 1Advocate Illinois Masonic Medical Center, University of Illinois at Chicago Metropolitan Group Hospitals, Chicago
JAMA Surg. 2018;153(3):282-283. doi:10.1001/jamasurg.2017.5521

A 25-year-old woman with a history of ulcerative colitis (UC) presented to the emergency department with lower abdominal pain. She received a diagnosis of UC 6 years earlier and has taken mesalamine to control UC. She was discharged a week before this admission for a UC flare that was managed with prednisone. Review of systems was notable for diarrhea; however, she denied hematochezia, melena, emesis, fevers, or changes in urination.

Her last colonoscopy was 3 years ago, and UC without evidence of dysplasia was confirmed. Otherwise, her medical history was unremarkable. Family history was negative for inflammatory bowel diseases and gastrointestinal malignancies. On examination, she was afebrile with normal vital signs. Her abdomen was tender to palpation in the left lower quadrant, which was soft and nondistended.

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