Comparative analysis between ischemic colitis and ulcerative colitis / 中华消化杂志

ABSTRACT

Objective To study the differences of clinical and histopathologic features between ischemic colitis (IC) and ulcerative colitis (UC), which can make for the differential diagnosis and treatments. Methods Comparative analysis were focused on the clinical and histopathologic data of IC patients (20 cases) and UC patients (30 eases). Results The onset duration of IC [(5±7) d] was significantly shorter than that of UC [(953±1354) d]. IC patients tended to have history of cadiovascular diseases or abdominal surgery (65%). The typical clinical manifestations of IC were sudden onset of abdominal pain (85%), hematochezia (60%)and diarrhea (50%), but UC usually presented with abdominal pain (83%), diarrhea (63%), bloody mucopurulent stool (57%) and tenesmus (20%). Colonoscopy showed longitudinal ulceration (60%)on the mesenteric side, the segmental lesions usually involved only 1/4-1/2 of the perimeter of the lumen (80%), and the boundary of lesions was clear (75%) in IC patients. On the contrary, the ulcer of UC was usually map-like (43%), the lesions usually involved the entire lumen (90%), and the pseudopolyp (37%) was another colonoscopic feature of UC. The histopathologic study revealed that dilation and hyperaemia of vessels (90%) were common in IC. Severe edema of mucosa (95%) was usually presented in IC, and the thickened vascular wall (50%) was the histopathologic characteristic of IC.Crypt abscesses (47%) usually appeared in UC. Conclusions The histopathologic characteristics and differences of colonoscopic findings and clinical features provide strong bases for the differentialdiagnosis between IC and UC.