Colon Ischemia: Recent Insights and Advances

Feuerstadt, Paul; Brandt, Lawrence J.

doi:10.1007/s11894-010-0127-y

Cited by 67 publications

(83 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The typical symptoms of general ischemic colitis are sudden, mild, abdominal pain and passage of red or bloody diarrhea [17]. However, symptoms of bloody diarrhea and abdominal pain were not found in our cases.…”

Section: Discussioncontrasting

confidence: 61%

Colonic ischemia following surgery for sigmoid colon and rectal cancer: a study of 10 cases and a review of the literature

Park

Hur

Min

et al. 2011

Int J Colorectal Dis

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 61%

Colonic ischemia following surgery for sigmoid colon and rectal cancer: a study of 10 cases and a review of the literature

Park

Hur

Min

et al. 2011

Int J Colorectal Dis

View full text Add to dashboard Cite

show abstract

“…In these patients, segmental ischemic colitis is a rare differential diagnosis of inflammatory bowel disease (5) and it results of a hypoxic tissue injury with secondary necrosis and inflammation (6). It may present a spectrum of severity ranging from mild, transient mucosal erosion to fibrous scarring with stricture formation or even transmural infarction (7).…”

Section: Discussionmentioning

confidence: 99%

Segmental colitis caused by idiopathic myointimal hyperplasia of mesenteric veins

Costa¹,

Saiote²,

Pinheiro³

et al. 2016

Rev Esp Enferm Dig

View full text Add to dashboard Cite

Diseases causing colonic ischemia may be mistaken with other causes of segmental colitis such as inflammatory bowel disease, especially in young patients. The authors present the case of a 47-year-old male with severe proctosigmoiditis. Assessment excluded infectious causes, thrombophilia and systemic vasculitis. The initial histological specimen was suggestive of inflammatory bowel disease and therapy was initiated with intravenous steroids and, at day 5, infliximab, with no response. The patient was proposed for surgery. Pathological examination of the surgical specimen revealed an idiopathic myointimal hyperplasia of mesenteric veins, a rare entity exhibiting necrotizing phlebitis with rapid progression to segmental necrosis in the rectosigmoid colon. In this paper the authors discuss the differential diagnosis of proctosigmoiditis in young ages and the approach to this exceptionally rare ischemic entity. INTRODUCTIONDiseases causing colonic ischemia may have similar presentation symptoms to other causes of segmental colitis such as inflammatory bowel disease, especially in young patients. Idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) is a rare condition causing segmental colonic ischemia that should be considered in the differential diagnosis of severe colonic inflammatory bowel disease refractory to intensive medical treatment. Preoperative diagnosis of IMHMV could be difficult as intimal thickening venules are in the submucosa and deeper layers. Even when a full-thickness biopsy is performed the diagnosis may be inconclusive. Standard treatment is surgical resection and there are no reports of postoperative disease recurrence. The following case illustrates this rare clinical condition in a young adult male patient. CASE REPORTA 47-year-old Caucasian male patient was admitted to our medical department on February 2012 with bloody diarrhea (more than 20 stools per day), lower abdominal cramping pain, proctalgia and malaise.The patient reported a previous 9 month history of hypogastric cramp-like pain, 4-5 small volume stools, without blood, mucus or pus, as well as a compelling urge to defecate and fecal incontinence. One month before, the patient had been assessed on the emergency department of another hospital due to clinical deterioration with anal pain, persistent urge to defecate, tenesmus and straining at stool. There, he had undergone a colonoscopy with biopsy and a pelvic CT scan. The colonoscopy showed edema of the rectal mucosa and sigmoid colon. The biopsies did not reveal any significant alterations. The pelvic CT scan identified parietal thickening of the rectum. At that time, the patient was treated with an antispasmodic. No improvement was observed.Patient's personal and family histories were irrelevant and epidemiological context was unremarkable. He had not been undergoing any other course of medication and denied known allergies, smoking, alcohol and history of injected or inhaled drug use.Upon physical examination, he was afebrile with lower abdominal tenderness w...

show abstract

“…The presence of the following findings suggests the existence of ischemic colitis: the spare of the rectum, segmental area of injury and hemorrhagic nodules that can also be detected in x-ray scan (thumb printingsign) [3,4,15,16]. The treatment depends on the severity of the episode and its etiology.…”

Section: B Gangrenous Ischemic Colitis (20%)mentioning

confidence: 99%

Untitled

2016

GHOA

View full text Add to dashboard Cite

Ergotamine toxicity is rare complication, including tachycardia, arterial spasm, or ischemic colitis which occurring as a result of a treatment with the drug du to different conditions. We report a 54-year-old woman using an ergot-derived drug for migraine. Diagnosis of ergotamine intoxication begins with suspicion. Every doctor and surgeons should be aware of this acute dangerous condition.Keywords: Ischemic colitis; Ergotamine every 100,000 people per year [1]. People affected by this entity are mainly female over 60 years old [2]. However, there are cases reported in young people with no risk factors. Its presentation runs between mild transitory episodes to fulminant colitis that can lead to necrosis, perforation, peritonitis and death. The risk factors identified are high blood pressure, diabetes mellitus, dyslipidemia, coronary disease and drugs, such as NSAIDs, ergotamine, cocaine, antibiotics, cytotoxic drugs and vasoactive agents [3][4][5][6]. Case ReportA 54-year-old female was admitted in the emergency department for 24 hour-longmigraines, diarrhea, lower gastrointestinal bleeding (15 episodes) and left lower abdominal pain. The patient is a former smoker (6 pack/year) with a record of dyslipidemia, thalassemia minor and chronic migraine treated with ergotamine suppositories.Physical examination showed normal vital parameters, abdomen with mild defense and no peritoneal irritation. Traces of blood were found during the rectal examination. ii. Abdominal CT: Irregular wall thickening (>3mm) along the left portion of the large bowel with no compromise of the rectum, pericolic fat stranding, submucosal edema and enhancement of the mucosa after intravenous contrast administration (Figure 1).A complete colonoscopy with previous mechanical bowel preparation was performed. The findings include segmental erythema and areas with pale mucosa from the splenic flexure to the rectosigmoideal junction, with rectal spare. Petechial hemorrhages, haustrations edema and fibrin were also described. Biopsy specimens were obtained.Histologic examination showed epithelium erosion, mucosal and sub mucosal hemorrhage, atrophic crypts and a decrease in the number of caliciform cells. These findings were consistent with ischemic colitis. Conservative treatment was established, with the suppression of the ergotamine suppositories. The patient was discharged 48 hours after admission. No recurrent symptoms were reported. A colonoscopy was performed 6 months after the diagnosis, which showed remission of endoscopic findings (Figure 2).

show abstract

Colon Ischemia: Recent Insights and Advances

Cited by 67 publications

References 38 publications

Colonic ischemia following surgery for sigmoid colon and rectal cancer: a study of 10 cases and a review of the literature

Colonic ischemia following surgery for sigmoid colon and rectal cancer: a study of 10 cases and a review of the literature

Segmental colitis caused by idiopathic myointimal hyperplasia of mesenteric veins

Untitled

Contact Info

Product

Resources

About