Endoscopic findings and clinicopathologic characteristics of eighty five patients with ischemic colitis

Abstract

Objective To evaluate the endoscopic findings and clinicopathologic characteristics of ischemic colitis in order to avoid misdiagnosis.Methods Eighty five patients with ischemic colitis who underwent endosopy within two weeks of onset of the symptom in center of Gulou hospital from Mar. 2005 to Apr.2008 were retrospectively reviewed for their endoscopic findings and clinicopathologic characteristics.All biopsy specimens were pathologically examined with HE and observed under light microscopy. Results The common features of 85 patients included abdominal pain,diarrhea or bloody diarrhea and hematochezia.The lesions were mainly located at left colon with segmental form(80%,68/85).Of 85 patients,non-gangraenous type was found in 82 and gangrenous type in 3.Endoscopic visualization of transient ischemic colitis included petechial hemorrhages,edematous and fragile mucosa,segmental erythema,scattered erosion,longitudinal ulcerations,and sharply defined segment of involvement.Stricture ischemic colitis was characterized by full-thickness mucosa,1umens stricture and haustrations disappeared.The characteristics of gangrenous colitis was cyanotic and pseudopolyps. Clinicoplathological examination revealed mucosal inflammation accompanied by erosion,granulation tissue hyperplasia and gland atrophy,lamina propria hemorrhage,especially maerophages with hemosiderin pigmentation in submucosa. Conclusions Although there is no specific changes in endoscopic findings and clinicopathologic characteristics,but early colonoscopy plays an important role in diagnosis of ischemic colitis,which is helpfull in management of ischemic colitis and reducing the misdiagnosis. Key words: Ischemic colitis; Endoscopy; Pathology