[Clinical outcomes in ischemic colitis: according to the colonoscopic extent and feature]

Ischemic colitis (IC) usually occurs in the elderly population and has a various clinical presentations from mild to severe forms. The aim of this study was to investigate the clinical outcomes according to the involved sites and colonoscopic findings in IC.

We retrospectively analyzed the medical records of 77 patients who had diagnosed with IC between January 2000 and July 2010. The clinical outcomes were compared according to numbers of the involved segments, location and endoscopic findings.

Mean age of the patients was 70±11 years and male to female ratio was 1 : 1.26. Hematochezia (67.5%) and abdominal pain (63.6%) were the most common associated symptoms. The colonoscopic examination was performed at mean 4.6±3.7 days after the symptom onset. The most common involved segment was the sigmoid colon (72.7%). Duration of fasting, antibiotics therapy, hospital stay and mortality were significantly increased in the patients group with more involved segments (p<0.001, p=0.004, p<0.001, p<0.001, respectively). Duration of antibiotics therapy and hospital stay were significantly longer in the right colon involvement group (p=0.038, p=0.002, respectively). The time taken until the alleviation of symptoms and the white blood cells count were significantly longer and higher in the ulcer or gangrenous group (p=0.001, p=0.022, respectively).

Evaluating the involved sites, the degree and severity of mucosal damage by colonoscopy may be important in predicting the clinical course and prognosis of the patients with IC. Early detection, careful monitoring and prompt treatment are crucial especially in the patients with ulcer or necrosis in colonscopic findings.