["Spontaneous" ischemic colitis: infectious or medicamentous colitis? 25 cases]

Area of Science:

• Gastroenterology
• Colorectal Diseases
• Microbiology

Background:

• Diagnosing non-gangrenous ischemic colitis is challenging due to non-specific histological findings and lack of clear cardiovascular triggers.
• The typical absence of relapse suggests external factors may initiate the condition.

Purpose of the Study:

• To investigate potential non-hemodynamic triggering events in spontaneous ischemic colitis.
• To identify similarities between ischemic colitis and colitis induced by specific drugs or infections.

Main Methods:

• Retrospective study of 25 cases of spontaneous ischemic colitis.
• Analysis of patient history for non-steroidal anti-inflammatory drug (NSAID) or antibiotic use.
• Review of cases associated with Escherichia coli O157:H7 infection.

Main Results:

• Nine patients had taken NSAIDs or antibiotics within two weeks of colitis onset.
• Three patients had concurrent Escherichia coli O157:H7 infection.
• Clinical, endoscopic, and histological features of NSAID-induced colitis, ampicillin-induced colitis, and E. coli O157:H7 infection-related colitis resemble ischemic colitis.

Conclusions:

• NSAIDs and E. coli O157:H7 intestinal infection are potential non-hemodynamic triggers for ischemic colitis.
• Antibiotic treatment, such as with ampicillin, may facilitate these triggers.
• These factors may cause acute colitis with characteristics similar to ischemic colitis.