Utilidad de la colonoscopia en la colitis isquémica / Usefulness of colonoscopy in ischemic colitis

Introducción: la colitis isquémica es la causa más frecuentede isquemia intestinal. Realizamos un estudio con el objetivo deanalizar las características demográficas, clínicas y la utilidad de lacolonoscopia en los pacientes diagnosticados de colitis isquémicaen nuestro centro en relación a un cambio de actitud terapéutica.Método: estudio retrospectivo en el que se seleccionaron 112pacientes diagnosticados de colitis isquémica mediante colonoscopiay biopsia, en un periodo de tiempo de cinco años. Se analizaron:edad, sexo, motivo de exploración, factores de riesgo cardiovascular,grado endoscópico de isquemia, cambio en la actitudterapéutica, tratamiento y evolución.Resultados: la edad media de nuestros pacientes fue de 73,6± 12,1 años con una incidencia similar en ambos sexos (50,9%mujeres y 49,1% hombres). Los factores de riesgo asociados fueronla hipertensión arterial (61,1%), el tabaco (37,2%) y antecedentede accidente cardiovascular previo (52,2%). El motivo másfrecuente de realización de colonoscopia fue rectorragia (53,6%)seguido de dolor abdominal (30,4%), realizándose de forma urgenteen el 65,3% de los casos. La colonoscopia permitió uncambio en la actitud terapéutica en el 50% de los casos, aumentandoen la urgente al 65,75%. La mortalidad global fue del27,67%. La colitis isquémica grave (25%) fue más frecuente envarones (64,3%), y cuando la indicación de colonoscopia fue urgente(85,71%) y cursó con mortalidad alta (53,57%). En estos serealizó tratamiento quirúrgico en el 57,14% de los casos con unaevolución favorable en el 50%, mientras que los pacientes con colitisisquémica leve o moderada tuvieron un pronóstico mejor, conevolución favorable en el 80,95% de los casos y con menor requerimientode tratamiento quirúrgico (4,76%, p < 0,05).Conclusión: la colitis isquémica es más frecuente en la edadavanzada. La sintomatología más común es la rectorragia y el dolorabdominal...(AU)

Background: the ischemic colitis is intestinal the most frequentcause of ischemia. With this work we determine the demographicand clinical characteristics, and the usefulness of thecolonoscopy in the patients with ischemic colitis diagnosed in ourcentre in relation to a change of therapeutic attitude.Method: retrospective study in which were selected 112 patientsdiagnosed with ischemic colitis by colonoscopy and biopsy,in a period of five years. It was analyzed: age, sex, reason for examination,factors of cardiovascular risk, endoscopic degree of ischemia,change in the therapeutic attitude, treatment and outcome.Results: the average age was of 73.64 ± 12.10 years with anequal incidence in women (50.9%) and the men (49.1%). The associatedfactors were the HTA (61.1%), tobacco (37.2%) and antecedentsof cardiovascular episode (52.2%). The most frequentreason for colonoscopy was rectorrhagia (53.6%) followed of theabdominal pain (30.4%), being urgent the 65.3%. Colonoscopyallowed a change in the therapeutic attitude in the 50 increasingin the urgent one to the 65.75%. Global mortality was of27.67%. The serious ischemic colitis (25%) was more frequent inmen (64.3%) in urgent indication (85.71%) and attends with highmortality (53.57%). Surgical treatment in the 57.14% was madewith a good evolution in the 50%, whereas the patients with mildor moderate ischemic colitis had a better prognosis (favourableevolution in 80.95%) with smaller requirement of the surgicaltreatment (4.76%), p < 0.05.Conclusion: the colitis ischemic are more frequent in the olderage. The most frequent symptoms are the rectorrhagia and theabdominal pain. The colonoscopy is a useful technique to evaluatethe gravity and it induces a change of attitude according to the resultof the same one. The evidence of a serious colitis supposedan increase of the necessity of surgery and worse prognosis(AU)

Usefulness of colonoscopy in ischemic colitis.

BACKGROUND: the ischemic colitis is intestinal the most frequent cause of ischemia. With this work we determine the demographic and clinical characteristics, and the usefulness of the colonoscopy in the patients with ischemic colitis diagnosed in our centre in relation to a change of therapeutic attitude. METHOD: retrospective study in which were selected 112 patients diagnosed with ischemic colitis by colonoscopy and biopsy, in a period of five years. It was analyzed: age, sex, reason for examination, factors of cardiovascular risk, endoscopic degree of ischemia, change in the therapeutic attitude, treatment and outcome. RESULTS: the average age was of 73.64 + or - 12.10 years with an equal incidence in women (50.9%) and the men (49.1%). The associated factors were the HTA (61.1%), tobacco (37.2%) and antecedents of cardiovascular episode (52.2%). The most frequent reason for colonoscopy was rectorrhagia (53.6%) followed of the abdominal pain (30.4%), being urgent the 65.3%. Colonoscopy allowed a change in the therapeutic attitude in the 50 increasing in the urgent one to the 65.75%. Global mortality was of 27.67%. The serious ischemic colitis (25%) was more frequent in men (64.3%) in urgent indication (85.71%) and attends with high mortality (53.57%). Surgical treatment in the 57.14% was made with a good evolution in the 50%, whereas the patients with mild or moderate ischemic colitis had a better prognosis (favourable evolution in 80.95%) with smaller requirement of the surgical treatment (4.76%), p < 0.05. CONCLUSION: the colitis ischemic are more frequent in the older age. The most frequent symptoms are the rectorrhagia and the abdominal pain. The colonoscopy is a useful technique to evaluate the gravity and it induces a change of attitude according to the result of the same one. The evidence of a serious colitis supposed an increase of the necessity of surgery and worse prognosis.