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Clinical features of ischemic lesions of the intestine: Focused on ischemic colitis

Clinical features of ischemic lesions of the intestine: Focused on ischemic colitis

Stomach and Intestine 28(9): 899-912

Eighty-two cases of ischemic colitis were analyzed for its clinical features. The results were summarized as follows. 1) There were significant differences in the following four items between 21 cases of the structuring form and 61 cases of the transient form; the age, melena or hematochizia, diseases associated with arteriosclerosis, and one hour value of erythrocyte sedimentation rate in the 5 days since the onset of symptoms. 2) The transient form of ischemic colitis and constipation prior to the onset of symptoms were more common in young patients (20 cases of 44 years old and under) than in older patients (16 cases of 70 years old and over). 3) Five out of 21 patients with the structuring form had tubular narrowing and delayed healing which were shown by x-ray examination. 4) There was recurrence of the disease in 5 patients (6.1%). 5) Negative cultures of bacteria including enterohemorrhagic Escherichia coli were important for the diagnosis of ischemic colitis. As ischemic lesions of the intestine excluding ischemic colitis, there are obstructive colitis, ischemic enteritis, ischemic colitis caused by oral contraceptives, posttraumatic ischemic stricture, ischemic lesion due to phlebosclerosis, amyloidosis, collagen disease, radiation enteritis, Schonlein-Henoch purpura, stercoral ulcer, and acute hemorrhagic ulcer of the rectum. In addition to above diseases, ischemic lesions may be caused by Escherichia coli O 157: H7-associated colitis, non-pseudomembranous penicillin-related colitis, ulcerative colitis, and Crohen's disease. Pathogenesis as well as clinical features should be discussed for the classification of ischemic lesions of the intestine.

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