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Evanescent colitis

  • Published:
Diseases of the Colon & Rectum

Abstract

Evanescent colitis was first reported in 1971. This clinical entity is manifested by abrupt onset of colicky abdominal pain usually out of proportion to the physical findings, loose stools progressing to hematochezia, and segmental colonic involvement with spontaneous resolution in a matter of days. The diagnosis can be suggested by abdominal flat plate; confirmation depends upon barium-enerna examination early in the course of the illness. The clinical presentation is identical to that of colonic ischemia with one remarkable exception; while colonic ischemia has come to be regarded as a disease of the elderly, usually with underlying vascular disease, evanescent colitis occurs in young people who are otherwise free of disease.

In this report the authors present nine cases whose course is classic for colonic ischemia except that they are all less than 50 years of age and free of underlying vascular disease. Two of the patients were on oral contraceptive medication. A review of the literature revealed 15 additional cases. Five of these cases were associated with oral contraceptives.

Conditions to be excluded in the differential diagnosis of this disease are the specific infectious colitides, idiopathic ulcerative colitis, granulomatous colitis and antibiotic-related pseudomembranous colitis

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References

  1. Boley SJ, Schwartz S, Lash J, Sternhill V. Reversible vascular occlusion of the colon. Surg Gynecol Obstet 1963;116:53–60.

    PubMed  CAS  Google Scholar 

  2. Boley SJ, Brandt LJ, Veith FJ. Ischemic disorders of the intestines. Curr Probl Surg 1978;15:4–85.

    Article  Google Scholar 

  3. O'Connell TX, Kadell B, Tompkins RK. Ischemia of the colon. Surg Gynecol Obstet 1976;142:337–42.

    PubMed  Google Scholar 

  4. Thomas ML. Further observations on ischaemic colitis. Proc R Soc Med 1968;61:341–2.

    PubMed  CAS  Google Scholar 

  5. Williams LF Jr. Vascular insufficiency of the intestines. Gastroenterology 1971;61:757–7.

    PubMed  Google Scholar 

  6. Williams LF Jr, Wittenberg J. Ischemic colitis: a useful diagnosis, but is it ischemic? Ann Surg 1975;182:439–48.

    Article  PubMed  Google Scholar 

  7. Carey JS, Okada F, Monson DO, Yao ST, Shoemaker WC. Intestinal infarction in shock with survival after resection: relation of the intestinal lesion to shock with high cardiac output. JAMA 1967;199:422–5.

    Article  PubMed  CAS  Google Scholar 

  8. Renton CJ. Massive intestinal infarction following multiple injury. Br J Surg 1967;54:399–401.

    Article  PubMed  CAS  Google Scholar 

  9. Rickert RR, Johnson RG, Wignarajan KR. Ischemic colitis in a young adult patient: report of a case. Dis Colon Rectum 1974;17:112–6.

    PubMed  CAS  Google Scholar 

  10. Turnbull AR, Isaacson P. Ischaemic colitis and drug abuse. Br Med J 1977;2:100.

    Google Scholar 

  11. Clark AW, Lloyd-Mostyn RH, Sadler MR. Ischaemic colitis in young adults. Br Med J 1972;4:70–2.

    Article  PubMed  CAS  Google Scholar 

  12. Dudley HA, Faris I. Ischaemic colitis without predisposing cause (correspondence). Br Med J 1971;3:637–8.

    PubMed  CAS  Google Scholar 

  13. Miller WT, DePoto DW, Scholl HW, Raffensperger EC. Evanescent colitis in the young adult: a new entity? Radiology 1971;100:71–8.

    PubMed  CAS  Google Scholar 

  14. Cotton PB, Thomas ML. Ischaemic colitis and the contraceptive pill. Br Med J 1971;3:27–8.

    PubMed  Google Scholar 

  15. Hurwitz RL, Martin AJ, Grossman BE, Waddell WR. Oral contraceptives and gastrointestinal disorders. Ann Surg 1970;172:892–6.

    Article  PubMed  CAS  Google Scholar 

  16. Kilpatrick ZM, Silverman JF, Betancourt E, Farman J, Lawson JP. Vascular occulusion of the colon and oral contraceptives: possible relation. N Engl J Med 1968;278:438–40.

    Article  PubMed  CAS  Google Scholar 

  17. Jones JH, Lennard-Jones JE, Young AC. Reversibility of radiological appearances during clinical improvement in colonic Crohn's disease. Gut 1969;10:738–43.

    PubMed  CAS  Google Scholar 

  18. Lindner AE, Marshak RH. Clinical and radiological features of ulcerative colitis. GP 1968 Feb 37:111–23.

    PubMed  CAS  Google Scholar 

  19. Alpers DH. The pseudomembranous enterocolitides. In: Sleisenger MH, Fordtran JS. Gastrøintestinal disease; pathology, diagnosis, management. 2nd ed. Philadelphia: WB Saunders, 1978:1715–30.

    Google Scholar 

  20. Morson BC. Histolpathology of intestinal ischaemia. In: Boley SJ, Schwarw SS, Williams LF Jr. Vascular disorders of the intestine. New York: Appleton Century Crofts, 1971:103–22.

    Google Scholar 

  21. Civetta JM, Kolodny M. Mesenteric venous thrombosis associated with oral contraceptives. Gastroenterology 1970;58:713–6.

    PubMed  CAS  Google Scholar 

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Read at the Meeting of the American Society of Colon and Rectal Surgeons, Hollywood, Florida, May 11 to 16, 1980.

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Heron, H.C., Khubchandani, I.T., Trimpi, H.D. et al. Evanescent colitis. Dis Colon Rectum 24, 555–561 (1981). https://doi.org/10.1007/BF02604324

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  • DOI: https://doi.org/10.1007/BF02604324

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