The epidemiology of ischaemic colitis

Higgins, Peter; Davis, Kourtney J.; Laine, Loren

doi:10.1111/j.1365-2036.2004.01903.x

Cited by 230 publications

(195 citation statements)

References 31 publications

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“…It occurs from impaired mesenteric blood flow either by occlusive vascular diseases or nonocclusive diseases [1]. The vasculature of the colon is low compared with the rest of the gastrointestinal tract; it is particularly sensitive to vasospasm, and its collateral blood flow is sparse [2].…”

Section: Discussionmentioning

confidence: 99%

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Ischemic Colitis after Hemorrhagic Shock Due to Obstetrical Reasons

Kasap¹

2015

CSMC

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IntroductıonIschemic colitis is the most common form of ischemic injury of the gastrointestinal tract and arises from occlusion, vasospasm, and/or hypoperfusion of the mesenteric vessels [1]. In this case, a patient who suffered from ischemic colitis due to acute postpartum hemorrhage after cesarean section was presented. *Corresponding author: Case PresentationA 28-year-old, gravid-2 para-2 women was diagnosed with preeclampsia and abruption of placenta at 30 weeks of gestation had been operated in emergency conditions at another hospital. Developing postpartum hemorrhage, firstly she was treated by conservative methods then transferred to our clinic in five hours. On the first examination, the patient was pale and hypotensive. Her pulse was weak and tachycardic.Blood was oozing from the pfanenstiel's incision and there was 1500 ml of blood in the abdominal drain. Initial blood tests showed hemoglobin to be 6.1 g/dl, leukocytes 11.200/mm 3 , platelets 58.500/mm 3 , INR 1.23, D-dimer >4000 ng/mL, aspartate transaminase 62 U/mL, calcium 7.2 mg/dL, and fibrinogen 166.8 mg/dL. She had coagulation failure and shock.Emergent laparotomy was performed since the patient did not respond to bimanual uterine massage and uterotonic medication. At laparotomy we found of 2L hemoperitoneum. Uterine atony responded poorly to conventional uterotonics, bimanual uterine massage and also uterine artery ligation and internal iliac artery ligation. When the B-Lynch suture also failed to control bleeding, we proceeded to hysterectomy. On the postoperative first day, she developed hypertension and tachycardia (blood pressure was 230/135 mmHg; heart rate range 136 bpm and was treated with Esmolol Hydrochloride, Amlodipine, Furosemide and Sodium Nitroprusside. Ceftriaxon 2 g/day was administered. She had passage of flatus on postoperative day 2 and 3 then stabilized on postoperative day 4.On the fifth postoperative day, the patient complained of nausea, vomiting, abdominal pain and distension. Her bowel sounds were hypoactive and urine output was decreased. Her condition continued to deteriorate, and she developed acute renal failure, pyrexia (38.4°C) and increasing distension of the abdomen rapidly. Antibiotherapy was changed as Meropenem (1000 mg 3 x 1) and Teicoplanin (400 mg 1 x 1).Abdominal examination revealed mild to moderate tenderness. In the plain abdominal radiograph, the colon was filled with gas, and the ascending colon's diameter was increased to 96 mm (Figure 1). Air-fluid levels were present in the dilated bowel loops on upright radiographs. Computed Tomography (CT) imaging showed widespread colonic dilatation (Figure 2). Her laboratory values were as follows; white blood count, 30.600/μl; hemoglobin, 10.6 g/dl; platelets, 202.000/μl. As intestinal perforation could not be excluded, a laparotomy was performed.At laparotomy, the whole colon, especially the ascending colon was found to be greatly distended as well as pale and ischemic. There was no evidence of mechanical obstruction, perforation or peritonitis. A rectal tu...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Ischemic Colitis after Hemorrhagic Shock Due to Obstetrical Reasons

Kasap¹

2015

CSMC

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“…[4][5][6]11 The aim of our study was to compare the characteristics of recurrent ischemic colitis to those of non-recurrent ischemic colitis and to identify the risk factors that predict recurrence.…”

Section: Sherid M Et Al Recurrent Ischemic Colitismentioning

confidence: 99%

“…An increasing elderly population is another consideration for the increase in diagnosis of ischemic colitis in recent decades, as ischemic colitis increases with advanced age. [4][5][6] Although the majority of cases of ischemic colitis have a self-limited course, which is usually resolved with conservative treatment, the major 30-day outcomes are significantly worse than those for patients with other colonic diseases. 2 The colon is protected against ischemia by an abundant collateral blood supply; however, it is still considered to have relatively poor collateral networks as compared with the small bowel and the stomach.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors of Recurrent Ischemic Colitis: A Multicenter Retrospective Study

Sherid

Sifuentes

Samo

et al. 2014

Korean J Gastroenterol

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3Background/Aims: Recurrence of ischemic colitis (IC) has not been studied extensively. The aim of this study was to investigate the characteristics of recurrent IC in the community setting and to identify any risk factors. Methods: We conducted a retrospective study in two community hospitals. Medical records of patients with IC from January 2007 to January 2013 were reviewed. Demographic details, clinical features, co-morbidities, concomitant use of medications, laboratory studies, imaging findings, endoscopic and histological features, surgery, hospital stay, and death within 30 days were collected. Patients were divided into two groups (recurrent IC group, non-recurrent IC group). Results: A total of 118 patients with IC were identified. IC recurred in 10 patients (8.5%) during the study period. Half of the patients in the recurrent IC group were current smokers as compared to only 18.7% of patients in the non-recurrent group. In the recurrent IC group, 20.0% of patients never smoked as compared to 61.7% in the non-recurrent group (p=0.027). Abdominal aortic aneurysm (AAA) was more frequent in the recurrent IC group (40.0% vs. 4.7%; p=0.003). No differences in other clinical symptoms, CT scan findings, comorbidities, endoscopic features, or use of concomitant medications were observed between the two groups. The need for surgical intervention, blood transfusion, intensive care unit stay, mechanical ventilation, length of hospital stay, and anatomic location of affected segments did not differ between the two groups. Conclusions: IC recurred in 8.5% of patients during the six-year study period. Current smoking status and presence of AAA were identifying risk factors for recurrence of IC. (Korean J Gastroenterol 2014;63:283-291)

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A 54-Year-Old Woman With Constipation-Predominant Irritable Bowel Syndrome

Lembo

2006

JAMA

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The epidemiology of ischaemic colitis

Cited by 230 publications

References 31 publications

Ischemic Colitis after Hemorrhagic Shock Due to Obstetrical Reasons

Ischemic Colitis after Hemorrhagic Shock Due to Obstetrical Reasons

Risk Factors of Recurrent Ischemic Colitis: A Multicenter Retrospective Study

A 54-Year-Old Woman With Constipation-Predominant Irritable Bowel Syndrome

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