P0275 - A Rare Case of Rustoleum-Paint Induced Ischemic Colitis in a Young Female Patient

Padmavathi Mali, MD
Gundersen Health Systems, Lacrosse, WI

Introduction: Ischemic colitis (IC) develops when blood flow to the colon is insufficient to maintain normal physiologic function. While IC is commonly seen in elderly patients, it can occur in young patients though less commonly. This case is unique as no etiology was identified in this patient who is diagnosed with IC other than us of Rustoleum Paint

Case Description/Methods: A 54-year-old female patient with a history of smoking, presented with abdominal pain followed by bloody diarrhea. Her vital signs on admission were Heart Rate (HR)130, Blood Pressure 126/73, and Temperature 98.6F. HR improved with intravenous fluid administration. Labs showed WBC 10.8 (nl 3.7-10.4 K/uL), hemoglobin 14.9 (nl 11.8-15.1 g/dL), and CRP 4.6 mg/dL (normal < 0.5 mg/dL). A CT scan of the abdomen showed significant edematous thickening of the left colonic wall with peri-colonic fluid and fat stranding with no peri-colonic abscess or perforation. Colonoscopy showed a fungating, infiltrative, ulcerated, and near completely obstructing large mass in the descending colon. The mass was circumferential and the entire extent of the mass could not be delineated as the pediatric colonoscope could not be advanced due to near complete obstruction. Biopsies were taken and the area was tattooed with an injection of India Ink. Biopsies came back as ischemic colitis with no malignant cells. Subsequently, a CT angiogram showed normal mesenteric arterial vasculature. Upon further questioning, her husband mentioned 6 hours prior to this episode of pain and hematochezia, she worked on one of the projects requiring Rust-oleum hard paint following which she felt dizzy and needed to lie down.

Discussion: Factors that can contribute to IC in young patients include blood clots, vasculitis, use of drugs like cocaine and amphetamines, and engaging in strenuous activities. This patient is unique in that she developed IC with the only identifiable etiology being the use of Rustoleum paint. High vapor concentrations of Rustoleum can be irritating to the eyes, throat, and lungs and can cause headaches and dizziness. This patient had dizziness and likely had hypotension from Rustoleum paint inhalation causing IC. This case highlights the importance of considering the possibility of ischemic colitis needs to be considered if presented with bloody diarrhea and abdominal pain after Rustoleum inhalation.



Disclosures:


Padmavathi Mali, MD. P0275 - A Rare Case of Rustoleum-Paint Induced Ischemic Colitis in a Young Female Patient, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.