Outcome of patients with ischemic colitis: review of fifty-three cases.
OBJECTIVE
Ischemic colitis is a disease of elderly patients and includes a wide clinical spectrum ranging from mild to severe forms. Some patients may develop complications. Management of this disorder depends on disease severity. Our aim was to review the clinical characteristics of patients diagnosed of ischemic colitis and analyze predictive factors of poor prognosis.


METHODS
This study is a retrospective analysis of 53 cases of ischemic colitis (33 men, 20 women), 35 with moderate and 18 with severe forms, respectively. Clinical characteristics, diagnostic procedures, segment of colon involved and long-term evolution after discharge were analyzed.


RESULTS
Hypertension (51 percent) was the main risk factor associated with ischemic colitis. Clinical presentation did not differ between groups, except for peritonitis which was present only in the severe group. Colonoscopy and histologic studies were the most used diagnostic procedures (90 percent). Peripheral vasculopathy (P < 0.01) and right colonic involvement (P < 0.001) were risk factors for severe outcome. Five patients died during admission. Among these, the right colon was affected in four (80 percent). No patient in either group developed chronic ischemic colitis during follow-up.


CONCLUSIONS
Ischemic colitis usually runs a benign course after acute colonic insult. Peripheral vasculopathy and right colonic involvement are associated with severe forms of ischemic colitis.
Medina
Carlos
C
Digestive System Research Unit, Hospital Universitario Vall d'Hebron, Barcelona, Spain. cmedinammar@hotmail.com
Vilaseca
Jaime
J
Videla
Sebastián
S
Fabra
Ramón
R
Armengol-Miro
J R
JR
Malagelada
J R
JR
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017091:Colitis, Ischemic / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D003113:Colonoscopy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome