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Colonoscopic findings of a typical colon ulcer.
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Based on a positive fecal occult blood test, she underwent total colonoscopy, which revealed multiple ulcers in various locations of the colon (Fig. 1).
An abdominal CT scan revealed free air in the peritoneal cavity (arrowheads).
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In addition to high levels of serum procalcitonin (70.5 ng/mL) and C-reactive protein (16.39 mg/dL), CT scan revealed massive free air in the abdominal cavity (Fig. 2).
Macroscopic appearance of the excised segment of the transverse colon bearing five ulcers (dashed lines) and a perforation (arrow).
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In addition, the nearby wall was thin and fragile, thus we performed en-bloc resection of this segment by colostomy (Fig. 3).
(a) Histological appearance of an ulcerative lesion of the transverse colon (hematoxylin and eosin staining, original magnification: 40x). (b) Immunohistochemical staining showed CMV-positive cells in the ulcerated lesion (original magnification: 400x).
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CMV-positive cells were found at all ulcer sites of biopsied specimens by colonoscopy and surgically resected specimens (Fig. 4).