[Ischemic colitis: two forms of clinical presentation and outcome]
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Published on: October 16, 2013
Jordi Blanco-Díaz1, José Ignacio Rodríguez-Hermosa, Marcel Pujadas de Palol
1Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain. montseny45@hotmail.com
Objectives:
To characterize the clinical presentation and outcomes of ischemic colitis in our environment with a view to identifying risk factors.
Method:
Fifty-one patients diagnosed in our hospital with ischemic colitis over a 5-year period (1998-2002) were retrospectively analyzed. Demographic data, clinical symptoms, diagnosis and treatment were studied. Two groups (surgical patients [n = 28] and nonsurgical patients [n = 23]) were compared.
Results:
No significant differences between the two groups were found in demographic data and associated disease. Diagnosis was performed by colonoscopy in nonsurgical patients and by analysis of the surgical specimen in almost all surgical patients. The presenting symptom was lower gastrointestinal bleeding in nonsurgical patients (p < 0.05) and peritonism in surgical patients (p < 0.05). Mortality was significantly higher in patients older than 80 years than in younger patients.
Conclusions:
Lower gastrointestinal bleeding was more common as the presenting symptom in transitory forms of ischemic colitis. An acute abdomen indicates serious forms requiring surgery. Therefore the initial clinical symptoms determine the treatment provided. Advanced age is a poor prognostic factor for ischemic colitis. Risk factors in our series were presentation as acute abdomen and advanced age.
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