Wang Wei, Xu Le
Department of Gastroenterology, Beijing Hospital, Ministry of Health, Beijing 100730, China.
Zhonghua Nei Ke Za Zhi. 2012 Oct;51(10):769-73.
To investigate the clinical manifestations, pathological features by endoscopy and possible risk factors of ischemic colitis (IC).
A retrospective analysis was made upon 89 hospitalized patients diagnosed as IC. Logistic regression analysis was performed to determine morbidity risk factors.
The majority of patients with IC in our study group had histories of hypertension, heart disease, hyperlipidemia, diabetes, etc. The common features included abdominal pain (80.9%, 72/89), hematochezia (76.4%, 68/89), etc. Colonic mucosal lesions presented regional distribution under colonoscope (80%, 72/89), with manifestations of petechial hemorrhages, edema, segmental erosion, pleomorphism ulcerations, visible lesion edge and sharply defined segment of involvement, even be characterized by lumens stricture (13.5%, 12/89). Histopathological examination revealed mucosa edema, necrosis, hemorrhage and formation of ulceration, inflammatory cell infiltration, and submucous hemorrhage, etc. Laboratory examination showed that white blood cells, neutrophils, serum fibrin, D-Dimer, serum TC, TG and serum apolipoprotein B were higher than normal. Colonic mucosal roughness, thumbmark symptoms, etc, and even bowel limited spasm, stricture or curtailment were visible in 47 patients underwent barium enema. Colonic wall thickening was visible in 29 patients underwent mesentericography, however, strictured or closed blood vessels were not found logistic regression analysis showed that hypertension, diabetes, higher TG, atrial fibrillation were strongly associated with onset of IC (all P values < 0.05).
Since IC symptoms are not typical, it requires early colonoscopy to clarify diagnosis. Hypertension, diabetes, hyperlipidemia, and atrial fibrillation are risk factors for IC.
