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Endoscopic and histopathological differences between antibiotic associated hemorrhagic colitis and ischemic colitis



Endoscopic and histopathological differences between antibiotic associated hemorrhagic colitis and ischemic colitis



Gastroenterological Endoscopy 27(3): 344-350



A comparative study between 22 cases of antibiotic-associated hemorrhagic colitis and 11 cases of ischemic colitis was performed by means of endoscopic and histological findings. Age of the patients ranged from 4-55 (mean, 29.3) in antibiotic-associated hemorrhagic colitis and from 22-84 (mean, 60.5) in ischemic colitis, respectively. Symptomatically, abdominal pain and bloody diarrhea were seen in all cases of both diseases. Colonoscopy with simultaneous biopsy was performed within 72 h after the onset. From an endoscopic point of view, hemorrhagic changes were observed in both groups. In cases of ischemic colitis, necrotic changes were additionally found in 9 of 11 cases (82%). Histologically, biospy specimens from antibiotic-associated hemorrhagic colitis showed hemorrhage of different degrees in the lamina propria in all cases. Necrotic changes were characteristically seen in biopsy specimens from ischemic colitis in 9 of 11 cases (82%). As the result, different pathogenesis is suggested between them. In ischemic colitis, mucosal necrosis develops due to occlusion or spasm of colonic blood vessels. In antibiotic associated hemorrhagic colitis, intramucosal hemorrhage is probably caused by capillary damage in the lamina propria of colonic mucosa, although its detailed mechanism remains unknown.

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Accession: 005359098

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