Ischemic colitis: Clinical, endoscopic and histologic spectrum of 254 cases

Abstract

SUMMARY
Aim: Ischemic colitis (IC) is generally considered a disease
of elderly patients who have associated diseases. It is
classified into the non-gangrenous type, and gangrenous
type. The aim of this study is to re-evaluate the clinical,
endoscopic and histological features of IC in the Greek
population.
Methodology: We retrospectively analyzed the clinical
characteristics, endoscopic and histologic findings in 254
patients (110 men and 144 women) with IC, diagnosed by
early endoscopy or surgical management.
Results: In non-gangrenous type (percentage: 84%) (127
women, 87 men), the patients´ age range was from 22 to 96
years (mean: 67 years), and 19/214 patients (8.8%) were less
than 50 years of age. The clinical features were: melena
(54%), abdominal pain (14%) and bloody diarrhea (10%),
and the early endoscopy (n=118) showed edema and focal
hemorrhage of mucosa (31%). The histological findings
were: mucosal atrophy, edema, hyperemia and mild acute
inflammation). In gangrenous type (percentage: 16%) (17
women, 23 men), the patients age range was from 57 to 89
years (mean: 73 years), and none of the patients were less
than 50 years of age. The main symptom was acute
abdominal pain (60%), and the histology showed acute
ischemic necrosis of the bowel wall in the whole population
(100%). Conclusion: IC is a rare disease in the Greek population.
The gangrenous type presents only in older patients (>50
years). The non-gangrenous type presents also in younger
patients, especially females, and early endoscopy is
essential for the accurate diagnosis of disease.
Key words: ichemic colitis, colon, clinicopathologic
correlation.