Abstract
We report a case of gangrenous-type ischemic colitis involving the bowel from thececum to the sigmoid colon. The patient, a 59-year-old woman, was admitted to our hospital complaining of abdominal pain and vomiting. The next day, rebound tenderness appeared on abdominal examination, and an emergency laparotomy was carried out. consecutive necrosis of the bowel from the cecum to the sigmoid colon was discovered. Under the diagnosis of gangrenous-type ischemic colitis, subtotal colectomy and exteriorization of both ends were performed resulting in her survival. In 49 cases of gangrenous-type ischemic colitis in the Japanese literature, the patients' ages ranged from 34 to 90 years (mean 70.2) with the majority in the seventh, eighth and ninth decades. There were 21 males and 22 females (6 unknown). The descending and sigmoid colon were most frequentlyinvolved. The mortality of 38 cases (11 unknown) was 44.7%, and in 36 resected cases, the mortality was 41.7%. This indicates poor prognosis of gangrenous-type ischemic colitis. The only therapy for survival is resection of the gangrenous area, and wide excision should be performed with observation of the intestinal mucosa of both ends.
