[Results of surgical treatment of ischemic colitis]

Between January 1984 and December 1989, 13 patients, aged 39 to 89 (median 63), underwent surgery for histologically proven ischemic colitis. Most suffered from pre-existing cardiovascular conditions (2 shortly after surgery for aortic aneurysm). One patient developed ischemia after the traumatic avulsion of the ileocolic artery and another after the spontaneous reduction of a strangled inguinal hernia. Diagnosis of ischemic colitis was made prior to operation in 4 instances only. The left colon was affected 5 times and the right colon 8 times (with the terminal coil of ileum 3 times). Treatment always consisted in segmental colectomy; laparotomy was used in 3 patients (2 to 7 reoperations). Colon anastomosis was performed directly 5 times, while 4 patients had secondary stomy closures; 2 patients still have their original stomy. Two patients died (15%), one of sepsis and the other following broncho-aspiration. The prognosis of ischemic colitis is rather favorable, even at the stage of transmural necrosis, provided all ischemic zones are resected. This is in contrast with the severe mortality of mesenteric infarcts, when extensive small bowel necrosis is found in association with colonic ischemia.