Chodoff Alaina, Whitehead Diana, Otieno Beryl, Fuscaldo Joseph
Department of Internal Medicine, Greater Baltimore Medical Center, Towson, MD, USA.
Department of Gastrointestinal Disease, Director of Inflammatory Bowel Disease, Greater Baltimore Medical Center, Towson, MD, USA.
J Community Hosp Intern Med Perspect. 2023 Jun 29;13(4):26-30. doi: 10.55729/2000-9666.1197. eCollection 2023.
The varied clinical presentation and objective findings associated with colonic ischemia (CI) overlap with multiple disease processes. A high index of suspicion is critical for timely diagnosis and prognostication to avoid delays in treatment. We present a case that highlights the challenges of diagnosing CI and the high morbidity associated with severe disease. Case report: A sixty-four-year-old female presented to our community hospital with acute onset abdominal pain, nausea, and diarrhea, complicated by septic shock. She was initially given a diagnosis of infectious colitis until a colonoscopy was performed revealing extensive pancolonic ulcerations. Histopathological features on biopsy were most consistent with colonic ischemia. Blood cultures grew . Surgery was avoided due to the high morbidity and mortality of performing a total colectomy and ileostomy. The patient continued to struggle with abdominal pain, diarrhea, and hematochezia, consistent with continuous CI, leading to recurrent hospitalizations.
与结肠缺血（CI）相关的多样临床表现和客观检查结果与多种疾病过程存在重叠。高度的怀疑指数对于及时诊断和预后评估至关重要，以避免治疗延误。我们报告一例病例，该病例突出了诊断CI的挑战以及严重疾病相关的高发病率。病例报告：一名64岁女性因急性腹痛、恶心和腹泻就诊于我们的社区医院，并并发感染性休克。她最初被诊断为感染性结肠炎，直到进行结肠镜检查发现广泛的全结肠溃疡。活检的组织病理学特征最符合结肠缺血。血培养结果为……由于行全结肠切除术和回肠造口术的高发病率和死亡率，避免了手术治疗。患者持续遭受腹痛、腹泻和便血困扰，与持续性结肠缺血相符，导致反复住院。
