Diagnóstico de Colitis isquémica. A propósito de un caso / Diagnosis of Ischemic Colitis. Case Report

Introducción: La colitis isquémica es la forma más común de isquemia intestinal. Es más frecuente en pacientes mayores de 65 años y están reconocidos los factores de riesgo de la enfermedad. Objetivo: Considerar el diagnóstico precoz de la enfermedad, mediante la realización de estudios diagnósticos determinados, en un paciente en quien se identifican factores de riesgo para la enfermedad. Presentación del caso: Se presenta un paciente con rectorragia. Al interrogatorio y examen físico se recogen factores de riesgo para la colitis isquémica. El diagnóstico se confirma por colonoscopía y las pruebas radiológicas ayudan a establecer la causa y el lugar de la isquemia. Conclusiones: El reconocimiento de factores de riesgo para la colitis isquémica permitió la sospecha de la enfermedad. Las pruebas diagnósticas, realizadas en un período precoz confirmaron el diagnóstico y permitieron buena respuesta al tratamiento(AU)

Introduction: Ischemic colitis is the most common form of intestinal ischemia. It is frequently observed in patients older than 65 years, and the risk factors of the disease are already known. Objective: To consider the early diagnosis of the disease in a patient in whom risk factors for the disease are identified after performing specific diagnostic tests. Case Presentation: A patient with rectal bleeding is presented. On questioning and physical examination, risk factors for ischemic colitis are identified. The diagnosis is confirmed by colonoscopy, and the radiological tests permitted to identify the cause and location of the ischemia. Conclusions: The identification of risk factors for ischemic colitis allowed to think on the possibility of the disease. Diagnostic tests, performed in an early period, confirmed the diagnosis and made a good response to treatment possible(AU)

Diagnostic Effects and Influence Factors of Emergency Colonoscopy in Patients with Acute Lower Gastrointestinal Massive Hemorrhage / 昆明医科大学学报

Objective To analyze the diagnostic effects and influence factors of emergency colonoscopy in patients with acute lower gastrointestinal massive hemorrhage. Methods 56 cases of patients with acute lower gastrointestinal massive hemorrhage treated in our hospital from May 2016 to May 2017 were selected and treated with emergency colonoscopy. The causes of acute lower gastrointestinal massive hemorrhage were analyzed and the emergency colonoscopy completion conditions in patients with different bowel preparation methods and different degrees of bleeding were compared. According to the results of emergency colonoscopy, the patients were divided into the successful test group and the failed test group, and the clinical data of the two groups were compared, and the influencing factors of the emergency colonoscopy were analyzed. Results The causes of acute lower gastrointestinal massive hemorrhage were colon cancer, colonic polyps,colon diverticulum and so on. There was no significant difference in the rebleeding or bleeding aggravation rate of different intestinal preparation methods (P＞0.05), and the detection rate of active bleeding in the severe hemorrhage group was higher than that in the mild hemorrhage group and the moderate hemorrhage group (P＜0.05) . In the emergency colonoscopy group, the number of patients in the successful test group, who were females, aged more than 45 years old, with a appendectomy history, a short walking time during the medication, an inadequate intestine preparation, unfinished lustramentum before examination, intestinal anatomical abnormalities and a non-standard physician operation,were lower than those in the failed test group (P＜0.05) . Logistic regression analysis showed that being female, aged over 45, inadequate bowel preparation and intestinal anatomical abnormalities were the independent risk factors for emergency colonoscopy failure in patients with acute lower gastrointestinal massive hemorrhage (P＜0.05) .Conclusions Emergency colonoscopy has important diagnostic significance for acute lower gastrointestinal massive hemorrhage especially the moderate to severe hemorrhage. Female, aged more than 45 years old, inadequate intestinal preparation and intestinal anatomical abnormalities are the independent influencing risk factor for diagnostic effects.