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Case Reports in Medicine
Volume 2016 (2016), Article ID 5217690, 3 pages
http://dx.doi.org/10.1155/2016/5217690
Case Report

Bowel Ischemia from Heat Stroke: A Rare Presentation of an Uncommon Complication

1Department of Internal Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
2Department of Gastroenterology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA

Received 3 July 2016; Revised 18 September 2016; Accepted 3 October 2016

Academic Editor: Gerald S. Supinski

Copyright © 2016 Umair Masood et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A healthy 27-year-old female presented to the hospital after she collapsed an hour into her first marathon run on a hot humid day. On presentation, she was hyperthermic, encephalopathic, tachycardic, and hypotensive. On admission, she was found to have lactic acidosis, rhabdomyolysis, and acute kidney injury and was treated with cold normal saline and cooling blankets. She subsequently started having abdominal pain and bloody bowel movements. Computed tomography of the abdomen revealed ascending colon thickening. Furthermore, her lab findings showed transaminitis and elevated coagulation parameters. Due to the acute hypotensive state from the heat stroke, patient had developed bowel ischemia, ischemic hepatitis, and disseminated intravascular coagulation, all of which are uncommon complications of heat stroke. She was managed aggressively with intravenous fluid hydration with resolution of her symptoms over the course of 4 days. In addition to the uncommon complications, early presentation of this bowel ischemia despite adequate hydration in such a healthy individual is another unique aspect of the case.