Published online Feb 6, 2020. doi: 10.12998/wjcc.v8.i3.552
Peer-review started: July 12, 2019
First decision: September 9, 2019
Revised: October 13, 2019
Accepted: October 30, 2019
Article in press: October 30, 2019
Published online: February 6, 2020
Processing time: 219 Days and 19.5 Hours
Core tip: Cytomegalovirus (CMV) enterocolitis presenting as toxic megacolon in an immunocompetent patient is rarely encountered. We report the case of a 70-year-old male with a non-immunocompromised state that presented with toxic megacolon and subsequently developed massive hemorrhage as a complication of CMV ileo-pancolitis. Although the diagnosis was delayed until massive hematochezia developed, the patient was treated successfully by repeat colonoscopic decompression and intravenous ganciclovir. A high degree of clinical suspicion is required to diagnose CMV enterocolitis, especially in immunocompetent patients, and this condition should be considered as a possible differential diagnosis in patients with intractable symptoms of enterocolitis or megacolon of unknown cause.