Clinical surgery–InternationalIschemic colitis
Section snippets
Patients and Methods
This retrospective study included 73 consecutive patients (51 women, 22 men; mean age, 73 y; range, 18–91 y) hospitalized in a University Department of general and digestive surgery from 1992 to 1999 for ischemic colitis. Cases of recurrent ischemic colitis and of ischemic colitis after aortic surgery or associated with obstructing colon carcinoma were excluded. For all patients, the diagnosis was documented pathologically either on examination of the surgical specimen or on biopsy specimens
Results
The past medical history of 25 patients included ischemia involving the myocardium (n = 20), and/or the lower limbs (n = 9), and/or the brain (n = 6). A cardiac arrhythmia was present in 18 patients and diabetes mellitus was present in 6. No patient had chronic renal failure. The use of drugs, suggested to be associated with an increased risk of ischemic colitis, was noted in 16 patients. This comprised anticonvulsants in 7 patients, cardiac glycoside in 6, diuretics in 6, and nonsteroidal
Comments
The spontaneous and usually self-limiting form of ischemic colitis contrasts with the fulminant or severe form. The rate of self-resolution of symptoms varies widely from medical to surgical experiences. In a medical series including 88 consecutive patients, the immediate course was uneventful in 92% of patients [7]. In surgical experiences, as in the present series, this rate was around 50% [8]. Ischemic colitis may be mistaken for fulminant Clostridium difficile colitis. The later presents
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