Case 29-1987

Presentation of CaseA 26-year-old man was admitted to the hospital because of obstructive jaundice.There was a history of inflammatory bowel disease that began at the age of 14 years and was treated successfully on an outpatient basis with prednisone. Two mild flare-ups occurred in subsequent years and were managed well with sulfasalazine. Flexible-sigmoidoscope examination one year before entry was reported to show only a few aphthous ulcers.The patient was well otherwise until three or four weeks before admission, when he experienced nausea, vomiting, chills, and a rise in the temperature to a maximum of 38.3°C, with prompt . . .