Usefulness of colonoscopy in ischemic colitis.
BACKGROUND
the ischemic colitis is intestinal the most frequent cause of ischemia. With this work we determine the demographic and clinical characteristics, and the usefulness of the colonoscopy in the patients with ischemic colitis diagnosed in our centre in relation to a change of therapeutic attitude.


METHODS
retrospective study in which were selected 112 patients diagnosed with ischemic colitis by colonoscopy and biopsy, in a period of five years. It was analyzed: age, sex, reason for examination, factors of cardiovascular risk, endoscopic degree of ischemia, change in the therapeutic attitude, treatment and outcome.


RESULTS
the average age was of 73.64 + or - 12.10 years with an equal incidence in women (50.9%) and the men (49.1%). The associated factors were the HTA (61.1%), tobacco (37.2%) and antecedents of cardiovascular episode (52.2%). The most frequent reason for colonoscopy was rectorrhagia (53.6%) followed of the abdominal pain (30.4%), being urgent the 65.3%. Colonoscopy allowed a change in the therapeutic attitude in the 50 increasing in the urgent one to the 65.75%. Global mortality was of 27.67%. The serious ischemic colitis (25%) was more frequent in men (64.3%) in urgent indication (85.71%) and attends with high mortality (53.57%). Surgical treatment in the 57.14% was made with a good evolution in the 50%, whereas the patients with mild or moderate ischemic colitis had a better prognosis (favourable evolution in 80.95%) with smaller requirement of the surgical treatment (4.76%), p < 0.05.


CONCLUSIONS
the colitis ischemic are more frequent in the older age. The most frequent symptoms are the rectorrhagia and the abdominal pain. The colonoscopy is a useful technique to evaluate the gravity and it induces a change of attitude according to the result of the same one. The evidence of a serious colitis supposed an increase of the necessity of surgery and worse prognosis.
Lozano-Maya
M
M
Service of Digestive Diseases, Section of Digestive Endoscopy, Hospital General Universitario Gregorio Marañón, Madrid, Spain. marlmaya@hotmail.com
Ponferrada-Díaz
A
A
González-Asanza
C
C
Nogales-Rincón
O
O
Senent-Sánchez
C
C
Pérez-de-Ayala
V
V
Jiménez-Aleixandre
P
P
Cos-Arregui
E
E
Menchén-Fernández-Pacheco
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017091:Colitis, Ischemic / Q000175:diagnosis* / Q000628:therapy; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult