Fatal ischemic colitis secondary to cytomegalovirus vasculitis in a renal transplantation patient

A 56-year-old female developed fever and right upper quadrant pain one month after renal transplantation. Computed tomography and barium enema examination revealed irregular thickening and narrowing of the ascending colon extending to the hepatic flexure. Urgent right hemicolectomy was performed as patient's condition deteriorated rapidly. Severe colitis with gangrenous change of ascending colon was evident during the operation. Histopathological examination for the resected specimen revealed cytomegalovirus infection with vasculitis and ischemic colitis. After the development of disseminated intravascular coagulopathy and internal bleeding, the patient unfortunately died four days after operation. Awareness of this rare cause of ischemic colitis is important because of frequent use of immunosuppresants in the organ transplant recipients.