We report the case of a 44-year-old white man who presented with
progressively worsening crampy abdominal pain and distention.
Deterioration of his clinical picture along with leukocytosis and
radiographic evidence of severe colonic dilation rendered exploratory
laparotomy necessary. Greatly distended and inflamed transverse and
descending colon were evident and an extended left colectomy was
performed. Characteristic changes of leukocytoelastic vasculitis in the
serosal and muscular layers of the resected colon were demonstrated at
histopathologic examination. Systemic leukocytoclastic vasculitis,
usually coexisting with Henoch-Schonlein purpura, commonly affects the
small bowel with clinical evidence of ischemia or bleeding. Colon
involvement is infrequently reported in the context of systemic disease.
Isolated colonic leukocytoclastic vasculitis without extraintestinal
manifestations is rare. A previously unreported case of localized
leukocytoclastic vasculitis of the left colon resulting in the
impressive presentation of megacolon, without the presence of any
precipitating factor or associated systemic disease is presented here,
with an overview of the related literature
