TY - JOUR T1 - Colon stricture after hemolytic uremic syndrome JF - World Journal of Pediatric Surgery JO - World Jnl Ped Surgery DO - 10.1136/wjps-2021-000261 VL - 4 IS - 2 SP - e000261 AU - Maria Luís Sacras AU - Catarina Ladeira AU - Sara Cordeiro Pereira AU - Rui Alves Y1 - 2021/05/01 UR - http://wjps.bmj.com/content/4/2/e000261.abstract N2 - Colonic stricture is a rare complication of hemolytic uremic syndrome (HUS). Risk factors include severe colitis, female gender and younger age. A clinical presentation of bowel obstruction in children, with previous known HUS, should prompt a contrast enema to rule out areas of stenosis. Surgical treatments consist of laparotomy, resection of the affected bowel and primary anastomosis.A 4 year-old girl was referred to the pediatric surgery emergency service presenting with subacute abdominal occlusion for 1 week prior to admission.The patient had a known history of HUS complicated by extensive colitis 3 months previously that required ventilation, transfusion support and renal replacement therapy. Verotoxin [also known as Shiga toxin (Stx)], which is associated with HUS enterocolitis from producing bacteria, mainly Escherichia coli O157:H7 and Shigella dysenteriae type 1, had been isolated, confirming the diagnosis of Shiga-like toxin producing E coli hemolytic-uremic syndrome (STEC-HUS or typical HUS).1 2 The patient was discharged after 48 days, with normal renal function (creatinine level of 0.4 mg/dL) but still with ongoing signs of mesenteritis on abdominal ultrasound, which were assumed residual.On admission, physical examination of the patient was unremarkable except for a marked abdominal distension. Hematological evaluation was normal. Abdominal CT scan revealed a 2 cm stenotic segment between the descending and sigmoid colons (figure 1). A contrast enema was performed, confirming colonic stenosis (figure 2).Figure 1 CT scan, after intravenous contrast injection, showing dilated descending colon … ER -