Greenwald D A, Brandt L J
Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA.
J Clin Gastroenterol. 1998 Sep;27(2):122-8. doi: 10.1097/00004836-199809000-00004.
Colonic ischemia encompasses a wide clinical spectrum from mild, reversible disease to severe, irreversible injury. It is a frequent disorder of the large bowel in the elderly, and can mimic certain diseases such as inflammatory bowel disease and neoplasms. The clinical course is variable, but often includes crampy, lower abdominal pain and the passage of red or maroon blood mixed with stool. In most cases, management is expectant, with supportive care and attention for signs of complicated disease. Prognosis typically is favorable, with a majority of patients completely resolving their illness; a minority go on to develop irreversible injury including strictures and chronic segmental colitis. Successful management of a patient with ischemic colitis requires a high degree of clinical suspicion, early diagnosis, careful follow-up, and prompt recognition of persistent disease.
结肠缺血涵盖了从轻度、可逆性疾病到重度、不可逆性损伤的广泛临床范围。它是老年人常见的大肠疾病，可类似某些疾病，如炎症性肠病和肿瘤。临床病程多变，但通常包括痉挛性下腹痛以及排出混有粪便的红色或暗红色血液。在大多数情况下，治疗以观察为主，给予支持性护理并留意复杂疾病的迹象。预后通常良好，大多数患者可完全康复；少数患者会发展为不可逆性损伤，包括狭窄和慢性节段性结肠炎。成功治疗缺血性结肠炎患者需要高度的临床怀疑、早期诊断、仔细随访以及及时识别持续性疾病。
