Pulmonary emboli causing sudden death in ulcerative colitis

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Sudden death as a complication of disease in children past infancy is rare. Sudden death in children with ulcerative colitis occasionally occurs following intestinal perforation, malignancy of the colon and surgical complications, but seldom preoperatively. Death secondary to bilateral pulmonary emboli associated with venous thrombosis is recognized as a complication of inflammatory bowel disease in adults, but has not been described in children.

The following case is that of a 15-year-old girl who died suddenly and unexpectedly from massive bilateral pulmonary emboli and is reported as an unusual complication and cause of death in ulcerative colitis in childhood.

Case report

A 15-year-old white girl first had bloody diarrhea in September 1967. Symptoms slowly increased in frequency and in December 1967 the diagnosis of ulcerative colitis was confirmed by barium enema and proctosigmoidoscopy. A low residue diet and an antimotility agent were prescribed. She continued to have one or two loose bowel movements daily. In December 1968 the diarrhea ceased and bowel movements were normal. In December 1969 diarrhea recurred and continued until November 1970, when the patient was first seen at the Bernalillo County Medical Center, Albuquerque, New Mexico.

Before or after the onset of diarrhea, the patient experienced no extracolonic complications of the disease. There was no family history of inflammatory bowel disease. The history did not reveal any serious physical illness. Six months prior to the initial onset of diarrhea, the girl’s mother, while under the influence of alcohol, was involved in an automobile accident resulting in the. . .



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