Journal List > Korean J Gastroenterol > v.60(1) > 1007000

Cho, Kim, Jung, Kim, Lee, and Jang: Clinical Outcomes in Ischemic Colitis: According to the Colonoscopic Extent and Feature

Abstract

Background/Aims

Ischemic colitis (IC) usually occurs in the elderly population and has a various clinical presentations from mild to severe forms. The aim of this study was to investigate the clinical outcomes according to the involved sites and colonoscopic findings in IC.

Methods

We retrospectively analyzed the medical records of 77 patients who had diagnosed with IC between January 2000 and July 2010. The clinical outcomes were compared according to numbers of the involved segments, location and endoscopic findings.

Results

Mean age of the patients was 70±11 years and male to female ratio was 1:1.26. Hematochezia (67.5%) and abdominal pain (63.6%) were the most common associated symptoms. The colonoscopic examination was performed at mean 4.6±3.7 days after the symptom onset. The most common involved segment was the sigmoid colon (72.7%). Duration of fasting, antibiotics therapy, hospital stay and mortality were significantly increased in the patients group with more involved segments (p<0.001, p=0.004, p<0.001, p<0.001, respectively). Duration of antibiotics therapy and hospital stay were significantly longer in the right colon involvement group (p=0.038, p=0.002, respectively). The time taken until the alleviation of symptoms and the white blood cells count were significantly longer and higher in the ulcer or gangrenous group (p=0.001, p=0.022, respectively).

Conclusions

Evaluating the involved sites, the degree and severity of mucosal damage by colonoscopy may be important in predicting the clinical course and prognosis of the patients with IC. Early detection, careful monitoring and prompt treatment are crucial especially in the patients with ulcer or necrosis in colonscopic findings.

Figures and Tables

Table 1
Baseline Characteristics of Patients
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Values are presented as mean±SD or n (%).

Table 2
Endoscopic Features of Ischemic Colitis
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Table 3
Clinical Features and Outcomes of the Patients with Ischemic Colitis according to the Number of the Involved Segments
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Values are presented as mean±SD, number, or n (%).

aStatistically significant.

Table 4
Clinical Features and Outcomes of the 71 Patientsa with Ischemic Colitis according to the Right Colon Involvement
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Values are presented as mean±SD, number, or n (%).

aThe 6 patients with pancolonic involvement were excluded and total 71 patients were analyzed.

bStatistically significant.

Table 5
Clinical Features and Outcomes of Patients with Ischemic Colitis according to Colonoscopic Mucosal Findings
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Values are presented as mean±SD, number, or n (%).

WBC, white blood cells.

aStatistically significant.

Table 6
Predictive Factors of Colonoscopic Features for Increased Fasting Duration by Multiple Regression Analysis
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Notes

Financial support: None.

Notes

Conflict of interest: None.

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