Ischemic Colitis: Clinical Presentation, Localization in Relation to Risk Factors, and Long-Term Results
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Ischemic colitis is commonly thought to occur most often in the left hemicolon close to the splenic flexure owing to insufficient blood supply near Griffith’s point. This study investigates the colorectal localization pattern, the risk factors, and the long-term outcome of histologically proven ischemic colitis.
Between 1996 and 2004, a total of 49 patients with a median age of 69 years (range 26–94 years) with colonoscopically assessed and histologically proven ischemic colitis were identified on behalf of the pathology database. Long-term results of 43 patients were evaluated retrospectively after a median interval of 79 months (range 6–163 months).
In 27 patients (55%) more than one location was affected. We found 98 affected locations in 49 patients. The distribution of ischemic colitis in our group shows no significantly preferred location. In an exploratory analysis, the cecum, ascending colon, and right flexure were affected significantly more often if intake of a nonsteroidal antiinflammatory drug (NSAID) is documented. There was no association between the location of ischemic colitis and a history of smoking, peripheral artery occlusive disease, coronary heart disease, diabetes, or malignant tumor.
Ischemic colitis seems not to have a predisposing site of occurrence in the colorectum, especially Griffith’s point which was not afflicted significantly more often than other sites. Frequently, ischemic colitis afflicts more than one colonic location. In patients being treated with NSAIDs, ischemic colitis was observed significantly more often in the right hemicolon. Recurrence of ischemic colitis seems to be rare.
KeywordsCoronary Heart Disease Inflammatory Bowel Disease Amyloidosis Splenic Flexure Inferior Mesenteric Artery
Conflicts of interest
The authors have no conflicts of interest or financial ties to disclose.
- 6.Scharff JR, Longo WE, Vartanian SM et al (2003) Ischemic colitis: spectrum of disease and outcome. Surgery 134:624–629; discussion 629–630Google Scholar
- 12.Zelenock GB, Strodel WE, Knol JA et al (1989) A prospective study of clinically and endoscopically documented colonic ischemia in 100 patients undergoing aortic reconstructive surgery with aggressive colonic and direct pelvic revascularization, compared with historic controls. Surgery 106:771–779PubMedGoogle Scholar
- 27.Steward JA, Rankin FW (1933) Blood supply of the large intestine: its surgical considerations. Arch Surg 26:843–891Google Scholar