Clinical, histological and endoscopical characterization in patients with ischemic colitis. A case series

Aims Ischemic colitis (IC) is a frequent colonic vascular disorder due to an imbalance in the colonic tissue between the oxygen intake and the oxygen need. Incidence is increasing because of the rise of cardiovascular risk factors prevalence and the ageing population.

1. Describe demographics, clinical features (risk factors, symptoms at presentation, mortality, and presence of thrombotic disorders), histologic samples results, days of admission, and surveillance after discharge in patients with endoscopic diagnosis of IC.

2. Determine the utility of histologic samples in IC.

Methods The study was developed under an observational and retrospective analysis including all patients with endoscopic diagnosis of IC between January 2013 and January 2022. Data was collected from endoscopic reports recorded in the Endoscopy Unit’s database. The descriptive analysis was performed using the IBM SPSS Statistics 25.0 software package.

Results A total of 690 patients were included, of whom 69.1% were female. The average age at diagnosis was 69.5 years old.

Most frequent cardiovascular risk factors were hypertension (68.8%), dyslipidemia (55,1%), and diabetes (30.1%). Most patients presented bleeding (81.9%), abdominal pain (72.6%) and/or diarrhea (55.2%) when arrival at hospital. 79.8% of patients were admitted, presenting a median rate of hospital stay of 6 days. Only 5 (0.73%) patients died due to IC.

After discharged, half of the patients were asked for ambulatory follow-up. Only 43 (6.2%) patients were investigated about thrombotic disorders, of which 4 were positive. [1] [2] [3]

During the endoscopic procedure, biopsies were taken in the 92.2% of patients. Histological confirmation was reached in the 73.9% of cases.

Conclusions Age and sex distribution are similar to that reported in other studies, being our series the biggest (N=690) at the moment.

1. According to physiopathology, hypertension, diabetes and dyslipidemia are notably present in our patients.

2. Mortality rate was lower than in other series.

3. Clinical management did not differ when biopsies were taken or not.

4. Prospective studies are needed before considering not necessary to take in these patients.

5. According to our results, endoscopic diagnosis is probably sufficient for the management of patients with ischemic colitis.

 

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Conflicts of interest

Authors do not have any conflict of interest to disclose.

• References

• 1 O’neill S, Yalamarthi S.. Systematic review of the management of ischaemic colitis. Colorectal Disease 2012; 14 (11) e751-e763
• 2 Cosme A, Montoro M, Santolaria S. et al. Prognosis and follow-up of 135 patients with ischemic colitis over a five-year period. World Journal of Gastroenterol 2013; 19: 8042-8046
• 3 Washington C, Carmichael J.. Management of ischemic colitis. Clinics in colon and rectal surgery 2012; 25 (04) 228-235

Publication History

Article published online:
15 April 2024