CLINICAL STUDY OF ISCHEMIC COLITIS

WITH SPECIAL REFERENCE TO BACHGROUND FACTORS AND ENDOSCOPIC FINDINGS

Abstract

We compared clinical features of 24 patients with ischemic colitis in primary hospitals and 17 such patients in a university hospital. For the patients in primary hospitals, the selection of which patients is not biased, ages were distributed almost uniformly from patients in their twenties to those in their seventies. The male-female ratio was 1 : 2. Arteriosclerosis-related diseases were seen in only 3 patients (13%). The stricture type of ischemic colitis was seen in only 2 patients (8%). These findings suggest that clinical features of ischemic colitis are not as generally believed. For all patients, woman more often had this disorder than man. Constipation, diarrhea following use of a purgative, after straining or after an enema were seen in more than half of the patients, whether the disease was transient or stricture type. Left-sided diverticulosis or laparotomy of the lower abdomen were often associated with ischemic colitis. The colitis often developed after evening meal. The results suggested that increased intraluminal pressure and peristalsis are triggers of ischemic colitis. It was difficult to make an accurate evaluation of the stricture type of this disorder by endoscopic findings within two weeks of the onset. It seemed that circular lesions after two weeks or longitudinal lesions after four weeks develop into the stricture type of this disease.