University of Connecticut Health Center, Division of Gastroenterology & Hepatology, 263 Farmington Avenue, Farmington, USA.
Expert Rev Gastroenterol Hepatol. 2013 Sep;7(7):605-13. doi: 10.1586/17474124.2013.832485.
Ischemic colitis is a common cause of hospital admissions; however it is frequently confused intellectually with mesenteric ischemia and often misdiagnosed as infectious diarrhea or Clostridium difficile colitis. Ischemic colitis is caused by non-occlusive insult to the small vessels supplying the colon without a clear precipitating factor. It is more common in females and in patients above 60 years of age. The classic presentation includes sudden onset of lower abdominal pain followed by the urge to defecate and bloody diarrhea. Focal right-sided ischemic colitis has more pain and a worse prognosis. Choosing the correct diagnostic studies is challenging and requires proficient knowledge of the disease. Management is usually conservative, however around 10-20% of the patients will require surgery. Acute ischemic colitis usually resolves; nevertheless some patients may develop chronic segmental colitis or a stricture. One ischemic colitis caveat is that it may be the first sign of undiagnosed cardiac disease. A firm grasp on this common yet little discussed condition is valuable to a gastrointestinal consultant and hospitalist alike.
缺血性结肠炎是住院的常见原因；然而，它在临床上常与肠系膜缺血相混淆，且常被误诊为感染性腹泻或难辨梭状芽孢杆菌结肠炎。缺血性结肠炎是由供应结肠的小血管非闭塞性损害引起的，没有明确的诱发因素。它在女性和 60 岁以上的患者中更为常见。典型表现为突发下腹疼痛，继而有便意和血性腹泻。右半侧局限性缺血性结肠炎疼痛更剧烈，预后更差。选择正确的诊断研究具有挑战性，需要对该疾病有熟练的了解。治疗通常为保守治疗，但约 10-20%的患者需要手术。急性缺血性结肠炎通常可缓解；然而，一些患者可能会发展为慢性节段性结肠炎或狭窄。缺血性结肠炎的一个注意事项是，它可能是未确诊的心脏疾病的首个征象。对这种常见但讨论较少的疾病有深入了解，对胃肠道顾问和医院医生都很有价值。
