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[Segmental ischemic colitis in lymphocytic thrombotic venulitis]

E Sanchez¹, C Soravia, E P Saraga

¹Service de chirurgie, Hôpital de zone, Payerne, Université de Lausanne.

Helvetica Chirurgica Acta

|September 1, 1993

Summary

Diagnosing colonic stenosis of ischemic origin can be challenging. This case highlights a rare venous ischemic colitis that responded well to conservative treatment, improving after initial misdiagnosis as neoplasia.

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Area of Science:

Gastroenterology
Vascular Surgery
Pathology

Background:

Colonic stenosis diagnosis can be difficult, especially when ischemic in origin.
Ischemic colitis is typically arterial, but venous causes exist.

Observation:

A 70-year-old female presented with symptoms suggestive of colonic obstruction, initially suspected as neoplasia.
Surgical exploration revealed induration and edema, with pathology confirming ischemic colitis due to lymphocytic thrombotic venulitis.

Findings:

The patient experienced recurrent stenosis after initial resection and anastomosis, diagnosed as recurrent ischemic stenosis.
Conservative management including anticoagulation, total parenteral nutrition (TPN), and steroids led to near resolution of the stenosis.

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Implications:

This case underscores the importance of considering venous ischemic colitis, even when rare.
Early diagnosis and conservative treatment can be effective for venous ischemic colitis, differentiating it from neoplastic conditions.