[Acute severe colitis with recto-vaginal fistula during treatment with non-steroidal anti-inflammatory agents].

INTRODUCTION: We report the case of severe colitis occurring during treatment with non-steroid anti-inflammatories (NSAI).

OBSERVATION: A 57 year-old woman was hospitalized for lumbar pain that had not been relieved by AINS, tramadol and then morphine. The patient presented with septic shock and peritonitis by rectal perforation, followed by acute rectorrhagia. The endoscopic aspect evoked Crohn's disease with a recto-vaginal fistula. Progression was further complicated by two episodes of collapse because of acute rectorrhagia, requiring hemostasis colectomy and abdominal-perineal amputation.

CONCLUSION: The diagnosis retained was AINS-induced colitis complicated by acute colectasia on a fecaloma with recto-vaginal fistula.