Diagnosis and treatment of ischemic colitis in elderly patients / 中华老年医学杂志

ABSTRACT

Objective To explore the clinical features of ischemic colitis (IC) in elderly patients for improving diagnosis and treatment. Methods The clinical symptoms, physical signs,underlying diseases, colonoscopic features, pathology features, laboratory examination and medical imageology data and prognosis were analyzed retrospectively in 12 patients with IC. Results (91.7%) had underlying diseases. They all had different degrees of abdominal pain, and experienced bloody stools after abdominal pain. Majority of them showed symptoms of nausea, vomiting and diarrhea. Colonoscopy showed that the most common lesions were located in the left colon (91.7%).Endoscopic appearances were edema, congestion and erosion of mucous membrane in colon,submucosal bleeding as well, and the lesion was longitudinal and demarcated with normal areas. The detection of plasma D-dimer and the imageology in all patients were normal. Conclusions IC should be suspected in elderly patients who have related underlying diseases accompanied by acute abdominal pain, hematochezia and gastric emptying symptoms. The early endoscopy is the first choice in the diagnosis of IC. Abdominal CT scan as well as the detection of plasma D-dimer have an important negative predictive value for IC.