Khanal Sneha, Bhatt Tanushree, Schmidt Patrik, Hallal Priscilla L, Zaw May
Internal Medicine, BronxCare Health System, The Bronx, USA.
Cureus. 2023 Mar 15;15(3):e36206. doi: 10.7759/cureus.36206. eCollection 2023 Mar.
Ischemic colitis, a potentially reversible pathology of the colon, can masquerade in its presentation as colonic carcinoma. It typically presents with cramping abdominal pain, diarrhea, and per-rectal bleeding. Colonoscopy remains the diagnostic modality of choice that typically shows friable, edematous, or erythematous mucosa with scattered hemorrhagic erosions or ulcerations. Although rare, the colonoscopic findings can sometimes reveal a tumor mass that confounds the diagnosis of ischemic colitis as colonic carcinoma. Our patient was a 78-year-old female with no previous colon cancer screening who presented with a mass-forming variant of ischemic colitis. Due to the overlap in presentations, radiographic findings, and colonoscopic findings, the diagnostic challenge was evident. Ultimately, colon cancer was ruled out through thorough colonoscopic follow-up and biopsy-guided pathological analysis. This case signifies the importance of considering colonic mass as a guise of underlying ischemic colitis to ensure an accurate diagnosis and the best possible outcome for the patient.
缺血性结肠炎是一种结肠潜在可逆性病变，其表现可能类似结肠癌。它通常表现为绞痛性腹痛、腹泻和直肠出血。结肠镜检查仍是首选的诊断方式，通常显示黏膜脆弱、水肿或红斑，伴有散在的出血性糜烂或溃疡。虽然罕见，但结肠镜检查结果有时会显示肿瘤肿块，这会混淆缺血性结肠炎与结肠癌的诊断。我们的患者是一名78岁女性，此前未进行过结肠癌筛查，表现为缺血性结肠炎的肿块形成型。由于临床表现、影像学表现和结肠镜检查结果存在重叠，诊断挑战显而易见。最终，通过全面的结肠镜随访和活检引导下的病理分析排除了结肠癌。该病例表明，将结肠肿块视为潜在缺血性结肠炎的一种表象对于确保准确诊断和为患者实现最佳预后非常重要。
