PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Colitis, Ischemic”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2005

Sonographic findings in ischemic colitis in 58 patients.

OBJECTIVE: The purpose of this study was to describe the sonographic findings of 58 patients with proven ischemic colitis and to evaluate whether any of the findings are related to the presence or development of transmural necrosis. MATERIALS AND METHODS: We reviewed the histories of patients diagnosed with ischemic colitis over a period of 5.5 years. Sixty-two patients had undergone sonographic examinations. The spectrum of sonographic findings in ischemic colitis was based on the original imaging report, with an analysis of the presence of colonic abnormalities and their associated alterations. In the second part of the study, we divided the patients into two groups according to the presence or absence of transmural necrosis, and the sonographic findings of each group were compared. Ten patients had sonographic follow-up studies during their hospital stay. RESULTS: The prospective sensitivity of sonography for the characterization of colonic abnormalities was 93.5% (58/62 patients). Segmental involvement was detected in 57 of the 58 patients, with left-sided colitis in 47 (81%). The mean length of bowel involved was 19 cm, with a mean wall thickness of 7.6 mm. Colon wall stratification was preserved in 38 patients (66%). Altered pericolic fat was observed in 16 patients (28%). Absence of or barely visible color Doppler flow in the thickened bowel wall was recorded in 80% of patients. Altered pericolic fat was the only sonographic variable significantly associated with the presence of transmural necrosis (p = 0.004). Improvement as assessed on sonography was observed in all patients with a good clinical course. In patients with transmural necrosis, sonography did not show improvement. CONCLUSION: Sonography is a valuable technique for the detection of colonic abnormalities resulting from ischemic colitis. In this study, altered pericolic fat or the absence of improvement in sonographic follow-up studies were factors associated with transmural necrosis.

Aged↗
PubMed1990

[Ischemic colitis as a cause of colon-engendered diarrhea].

A detailed description of the typical clinical symptoms of ischemic colitis reveals, in which rare cases this illness is the cause of cologenic diarrhea. Initial laboratory findings are after not specific and are not of much diagnostic use, except when this itself hints at the possibility of ischemic colitis. On the other hand, contrast enema and endoscopy yield definitive information. The diagnosis can be confirmed by means of a biopsy. The question why one should follow conservative expectant therapy rather than surgery, when there is a strong suspicion or even proof of ischemic colitis, is discussed. Possible variations of the course of ischemic colitis and their therapeutic consequences are discussed.

Barium Sulfate↗
PubMed1987

Quantitative evaluation of experimental ischemic colitis correlated with the degree of artificial bowel obstruction in rats.

Experimental ischemic colitis proximal to artificial bowel obstruction was produced under poor regional circulatory conditions in rats. Only the vessels of the left hemi-colon were ligated to obtain poor circulation (ischemia). Two types of aluminum rings were used to obstruct the bowel at the most distal portion of the ischemic colon. One, with a 4 mm internal diameter, was used for the model of partial colon obstruction with ischemia (partial obstruction, n = 25) and the other, with a 2 mm internal diameter, was used for complete colon obstruction with ischemia (complete obstruction, n = 25). The circumference of the dilated bowel was larger in complete obstruction than in partial obstruction. Ischemic colitis developed in 9 of 25 rats (34.0%) with partial obstruction and 16 of 25 (64.0%) with complete obstruction. In terms of morphometry, over half of the ischemic lesions in complete obstruction were more than 1.0 cm2, but such a large size in partial obstruction was not observed. It was demonstrated that the depth of ischemic lesions gradually increased in extensive lesions. In conclusion, complete colon obstruction with ischemia frequently caused severer ischemic colitis, together with marked distention of the proximal bowel, than partial colon obstruction with ischemia.

Animals↗
PubMed2000

Right colonic involvement is associated with severe forms of ischemic colitis and occurs frequently in patients with chronic renal failure requiring hemodialysis.

OBJECTIVE: The aim of this study was to identify factors associated with severe outcome in patients with ischemic colitis. METHODS: The files of 60 consecutive inpatients (34 women, 26 men, mean age 67 yr) with ischemic colitis were reviewed. The following data were analyzed: age, sex, smoking, medications, history of cardiovascular disease, metabolic disease, chronic renal failure and hemodialysis, the time elapsed between the first symptoms and the diagnosis, and the site and extension of their colonic involvement. Patients were divided into two groups according to outcome: those with severe disease, including those who died from ischemic colitis (n = 3) or who required surgical resection (n = 21); and those with mild forms of colitis who were treated successfully without surgery (n = 36). The two groups were compared by means of univariate and multivariate analysis to identify factors associated with unfavorable outcomes. Only patients who had a complete examination of the colon (n = 51) were entered into the statistical analysis. RESULTS: By univariate analysis, chronic renal failure (p = 0.03), hemodialysis (p = 0.01), short delay between symptoms and diagnosis (p = 0.01), and right colonic involvement (p = 0.002) were significantly more common in the patients with severe colitis. By logistic regression, right colonic involvement was the only factor independently associated with severity (p = 0.01). Right-sided lesions were present in 82% of patients on dialysis but in only 26% of patients not on dialysis (p = 0.0005). CONCLUSIONS: Right colonic involvement is associated with severe forms of ischemic colitis and occurs frequently in patients with chronic renal failure requiring hemodialysis.

Adult↗
PubMed1979

Incidence of ischemic colitis following abdominal aortic reconstruction.

The incidence of ischemic colitis following abdominal aortic reconstruction was determined by postoperative colonoscopy during a three year period. The over-all incidence of colitis was 11 of 163 patients who underwent elective or urgent reconstruction of the abdominal aorta for aneurysmal and occlusive diseases. The incidence of ischemic colitis for patients who survived resection of ruptured abdominal aortic aneurysms was higher, although the colonoscopy rate was lower. The incidence might have been even higher if all patients surviving resection of ruptured abdominal aneurysms had undergone colonoscopy.

Aorta, Abdominal↗
PubMed1994

Premarin-induced ischemic colitis.

There are numerous literature reports of oral contraceptive-induced (estrogen and progesterone) ischemic bowel disease. However, Premarin-induced (equine conjugated estrogen) intestinal ischemia has rarely been reported. We describe three cases of Premarin-induced ischemic colitis. In contrast to oral contraceptive-induced ischemic colitis, Premarin-induced ischemia is restricted to the colon, has not required surgical therapy, can have a chronic or chronic intermittent course, may be reversible despite continued usage of Premarin, and may present with nonspecific abdominal and colonic symptoms.

Adult↗
PubMed1991

Preoperative prediction of extent and severity of ischemic colitis by imaging with in-111 labeled leukocytes.

Ischemic colitis is a relatively common clinical entity. Conservative medical management is successful for most patients, but surgical intervention is required for patients with intractable disease. Noninvasive determination of the site and extent of the disease can be helpful in the preoperative decision on the surgical approach in these debilitated patients. However, current radiologic studies individually are inadequate in this respect. Based on the clinicopathologic correlation obtained after imaging with In-111 labeled leukocytes in a patient with ischemic colitis, the authors believe that this procedure may be useful; further studies in a larger patient population are warranted.

Colitis↗
PubMed2005

Tegaserod-associated ischemic colitis.

Tegaserod, a potent partial agonist of the serotonin 5-HT4 receptor, is used to treat women with constipation-predominant irritable bowel syndrome. Since the drug's approval, the manufacturer has received infrequent although serious reports of diarrhea and ischemic colitis in patients taking the drug. These instances have led to a recent warning letter to physicians and a change in the prescription labeling of tegaserod. We describe the development of ischemic colitis in a woman who was treated with tegaserod and review the relationship among ischemic colitis, tegaserod use, and irritable bowel syndrome. Potential mechanisms involved in the occurrence of ischemic colitis in patients receiving tegaserod are also discussed.

Adult↗
PubMed2000

Prognosis of ischemic colitis: comparison of color doppler sonography with early clinical and laboratory findings.

OBJECTIVE: The objective of this study was to compare the value of color Doppler sonography with early clinical and laboratory findings in determining the prognosis of patients with ischemic colitis. SUBJECTS AND METHODS: We reviewed the early clinical, laboratory, and color Doppler sonographic data of 24 patients with ischemic colitis. The patients were divided into two groups on the basis of their outcome. The first group comprised the patients with transient ischemia who recovered uneventfully, and the second group included the patients who needed surgery because of symptomatic transmural colic gangrene or colic stricture. Clinical data and laboratory values were compared with color Doppler sonographic findings including colic wall thickness, presence of stratification, and arterial flow in the bowel wall. RESULTS: At univariate analysis, increased age (p = 0.007), leukocyte count (p = 0.030), lactate dehydrogenase level (p = 0.030), blood lactate level (p = 0.041), and absence of vascular flow in the colic wall (p<0.001) were significantly related to complicated ischemic colitis. At multivariate analysis, absence of arterial flow was the only significant predictor of complicated ischemic colitis (p = 0.002), with a sensitivity of 82%, a specificity of 92%, a positive predictive value of 90%, and a negative predictive value of 86%. CONCLUSION: Absence of arterial flow in the wall of the ischemic colon on initial color Doppler sonography is suggestive of an unfavorable outcome and is more closely associated with outcome than early clinical and laboratory findings.

Aged↗
PubMed1989

Ischemic colitis following abdominal aortic reconstruction for ruptured aneurysm. A 10-year experience.

Between January 1, 1978, and December 31, 1987, a total of 103 patients had operations for ruptured abdominal aortic aneurysms. The average age was 73 years (range, 53 to 91 years). Thirty-two patients died during surgery or in the immediate postoperative period. In 19 of the remaining 71 patients ischemic colitis developed, an incidence of 27 per cent. This report reviews the clinical findings and course of these patients. The average age of patients developing ischemic colitis was 72 years (range, 53 to 90 years), not significantly different from the group as a whole. There was no correlation between the type of vascular reconstruction and the development of ischemic colitis. Eleven patients died and eight survived, for a mortality rate of 58 per cent. The most common clinical finding was diarrhea early in the postoperative period, which was noted in 20 patients. Thirteen of these patients had ischemic colitis confirmed by flexible sigmoidoscopy. Eight (62%) of these 13 patients survived; three were managed nonoperatively and five had colectomy. Six patients presented between postoperative days 9 and 20 with signs of increasing sepsis but with no diarrhea or other significant clinical findings; ischemic colitis was confirmed by sigmoidoscopy in all six patients. All of these patients died of septic complications. Seven patients with early postoperative diarrhea had normal sigmoidoscopic findings. None developed septic complications and five survived; two died of cardiac events.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

Mortality from ischemic colitis.

Thirty-nine hospital-based cases of ischemic colitis were reviewed. There were 18 males and 21 females. Average age was 68.7 years (range, 18 to 92 years). Associated diseases among 13 patients younger than 65 included renal failure in seven patients and hematologic, vasculitic, or collagen vascular diseases in four. In 26 patients 65 or older, congestive heart failure was seen in 13, vascular disease in eight, and previous aortic surgery in four. Nineteen patients were treated nonsurgically and 8 died (42 percent mortality). Twenty patients (51 percent) underwent surgery: 18 had resection with colostomy or ileostomy and two had resection with reanastomosis; one patient underwent laparotomy followed by second-look exploration without resection. Thirteen of the 20 surgical patients died (65 percent mortality). Both patients who underwent reanastomosis died of sepsis. The data show a close association between ischemic colitis and a number of serious systemic diseases including renal failure, arteriosclerotic heart and vascular disease, and hematologic, vasculitic, and connective-tissue disease. A predilection for the right colon and sigmoid colon and splenic flexure was seen. A formidable mortality rate (53 percent) was found among patients treated both surgically and nonsurgically.

Adolescent↗
PubMed2005

Ischemic colitis following colonoscopy in a systemic lupus erythematosus patient: report of a case.

BACKGROUND: Ischemic colitis is an uncommon complication in patients with systemic lupus erythematosus but may be precipitated by colonoscopy. CASE REPORT: A 43-year-old female with systemic lupus erythematosus under treatment with immunosuppressive drugs and prednisone was submitted to colonoscopy because of a change in bowel habit. Apart from the presence of a small metaplastic polyp, colonoscopy showed only a few erythematosus areas in the sigma and left colon. Four hours after colonoscopy, the patient developed lower colic abdominal pain and mucous diarrhea followed by rectal bleeding from ischemic colitis. The patient was successfully treated with fluids, spasmolytic drugs, sodic heparin, antibiotics and enteral feeding. CONCLUSIONS: Awareness of the risk of this potential complication, secondary to colonoscopy, in patients with connective tissue disorders may lead to a prompt diagnosis and effective treatment, with a successful outcome.

Adult↗
PubMed1996

Ischemic colitis complicating abdominal aortic aneurysm surgery in the U.S. veteran.

Ischemic colitis (IC) is an infrequent but serious complication of abdominal aortic surgery. Prior reports have generally described small, selected populations. The aim of this paper is to evaluate characteristics of clinically diagnosed IC in a large non-referral-based population. Using national Veterans Affairs (VA) computer data sets, we identified all patients with the diagnostic codes for both prosthetic replacement of aorta for abdominal aortic aneurysm and subsequent vascular insufficiency of the intestine in the entire VA population from 1987 to 1991. Clinical information on these patients was then requested from the VA Medical Centers where they received care. Patients demographics, clinical data regarding both the aortic surgery and IC, and survival data were extracted from patient charts and computer records. Of 4957 patients who underwent surgery of the abdominal aorta for infrarenal abdominal aortic aneurysm, 58 (1.2%) also had the code for subsequent IC. In 49/58 (74%), sufficient chart-derived and computer-derived data were available for analysis. The mean age was 69 (range 57-95); all were males. Bloody diarrhea was the most frequent symptom and colonoscopy the most common means of diagnosis. Mean time to diagnosis of IC was 5.5 days after aortic surgery (range 1-21 days). Aneurysmal rupture or perioperative hypotension were present in 35/49 patients. Bowel resection with fecal diversion was required in 32/49 (65%). The overall mortality was 54% but it was 89% if bowel resection for bowel infarction was required. Only 2/12 (16%) of those who required fecal diversion and survived underwent eventual stoma closure. Among 7 patients who received second-look laparotomy for IC, additional bowel resection was required in 6. No patient had aortic graft infection diagnosed during the index hospitalization. The overall mean hospitalization duration after the diagnosis of IC was 38 days (range 1-164). IC following aortic aneurysm surgery in this national patient population is infrequently diagnosed. Emergency aneurysm operation and perioperative hypotension are common in patients who develop IC. The majority of patients diagnosed receive surgical intervention. Most patients who undergo fecal diversion retain their stomas.

Aged↗
PubMed1993

[Ischemic colitis localized in the right colon. A clinical case report].

Ischemic colitis shock-associated still is a not well-defined clinical entity. The authors describe symptoms, clinical course and treatment in a case recently observed. They outline the difficulties of preoperative diagnosis and the need of a not postponable surgical treatment due to shock and peritonitis.

Adenocarcinoma↗
PubMed2004

[Ischemic colitis and hemophagocytosis complicating Kawasaki disease].

UNLABELLED: Gastrointestinal manifestations of Kawasaki disease are usually limited to stomatitis, paralytic ileus, and hydrops of the gallbladder. We report a case of Kawasaki disease complicated with hemophagocytosis and ischemic colitis. CASE REPORT: A 5-year-old girl with Kawasaki disease presented with hemophagocytosis that responded to gamma-globulin therapy. On day 4 she had abdominal pain and diarrhea. CT scan showed features suggesting ischemic colitis. Symptoms resolved on total parenteral nutrition. CONCLUSION: Ischemic colitis and hemophagocytosis are potential severe complications of Kawasaki disease.

Child, Preschool↗
PubMed2004

Lethal cytomegalovirus ischemic colitis presenting with fever of unknown origin.

We report a fatal case of cytomegalovirus (CMV) ischemic colitis in a renal transplant recipient. The disease was manifested with fever of unknown origin for 27 days followed by progressive right lower abdominal pain. The clinical condition deteriorated rapidly with development of disseminated intravascular coagulopathy and internal bleeding despite right hemicolectomy and antiviral therapy. The patient died 11 days after the onset of abdominal pain. We conclude that the possibility of CMV ischemic colitis should be suspected if a patient presents with fever and abdominal pain in the early months after transplantation, and that early viral detection by CMV polymerase chain reaction can be lifesaving.

Colectomy↗