Nonocclusive ischemic colitis secondary to hemorrhagic shock

Abstract

A young male with a penetrating chest wound suffered modest and transitory hemorrhagic shock. Nonocclusive right-sided ischemic colonic necrosis developed secondarily. This became obvious on serial follow-up examinations, prompting exploration and curative surgical resection. This case represents ischemic colitis secondary to hemorrhagic shock following trauma. Upon review of the literature, only five other such cases have been reported. Although shock-associated ischemic colitis is well documented, it is extremely uncommon to see gangrenous changes of the bowel in young, otherwise healthy, trauma victims. Mesenteric vasospasm is believed to be the causative factor in these cases. For unknown reasons, the right colon seems to be the favored site of ischemic damage. Nonocclusive intestinal ischemia should be considered in patients who have abdominal pain after a hypotensive episode.