Two Cases of Ischemic Colitis Accompanied with Elevated Serum CEA

Keiko Iwaisako, Naoko Kamo, Satoru Seo and Minoru Ukikusa

Department of Surgery, Osaka Red Cross Hospital

We report two cases of ischemic colitis accompanied by elevated serum CEA. The mechanism behind elevated CEA is unknown, but benign conditions that elevate CEA include ischemic colitis. Patient 1: An 87-year-old woman admitted for abdominal pain and vomiting was found to have serum CEA elevated to 62.7 ng/ml. Suspecting intestinal obstruction associated with colorectal cancer, we conducted laparotomy, finding necrotic change from the transverse colon to the sigmoid colon but no tumor. Resected specimens following left hemicolectomy and temporary ascending colostomy showed acute gangrenous ischemic colitis but no malignancy. Her serum CEA returned to the normal range 6 days later. Patient 2: A 77-year-old man admitted for septic shock was found to have serum CEA elevated to 25.0 ng/ml. Suspecting malignancy, we conducted colonic fiberscopy, finding an ischemic sigmoid colon but no tumor. After half a year of conservative treatment, his serum CEA gradually decreased to the normal range. Serum CEA is known to occur at high positive rates in patients with malignant tumors.

Key words
carcinoembryonic antigen, ischemic colitis

Reprint requests
Keiko Iwaisako Department of Surgery, Kyoto University Graduate School of Medicine
54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507 JAPAN

Accepted
November 28, 2007

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