Ischemic colitis is an uncommon disease in Korea, but nowadays, the incidence of this disease is increasing in Korea. The reason is that the number of old patients is increasing and colonoscopic diagnosis is performed more frequently. It is especially important to differentiate it from other inflammatory bowel disease, such as infectious colitis, ulcerative colitis, Crohn's disease, and drug-induced colitis, because ischemic colitis is similar to other inflammatory bowel disease in symptoms and colonoscopic findings. However, the authors were able to differentiate ischemic colitis from other inflammatory bowel disease by close examination of a patient's history, microscopic examination and culture studies of the bacteria in the stool, and close observation of the changes in the colonoscopic findings with time. We experienced six cases of ischemic colitis and report them along with a brief review of the literature.
Bacteria ; Colitis ; Colitis, Ischemic* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Korea

Therefore differential diagnosis from idiopathic ulcerative colitis will be needed. Recently, we have examined a 20 year-old Korean female patient who had the complaints of acute lower abdominal pain and bloody diarrhea. The diagnosis of ischemic colitis was confirmed on the basis of colonoscopic and associated histopathological findings. The patient dis-charged with good improvement on the thirteenth hospital day after medical treatment with antibiotics, fluid and electrolytes. We report a case of reversible ischemic colitis of descend-ing colon of a young woman with literature review.
Abdominal Pain ; Anti-Bacterial Agents ; Colitis, Ischemic* ; Colitis, Ulcerative ; Colon ; Diagnosis ; Diagnosis, Differential ; Diarrhea ; Electrolytes ; Female ; Humans ; Young Adult

BACKGROUND/AIMS: The aim of this study was to investigate the value of colonoscopy for Salmonella-Shigella culture of biopsy specimen and intraluminal fluid during colonoscopy in patients with acute diarrhea. METHODS: From March 2001 to August 2001, sixty-six patients with watery or bloody diarrhea lasting less than 15 days were participated after exclusion of the patients with previous history or presumption of inflammatory bowel disease, radiation colitis, ischemic colitis, or pseudomembranous colitis. The biopsy specimen was taken and colonic luminal fluid was aspirated during colonoscopy for Salmonella-Shigella cultures. RESULTS: Male and female ratio was 1:1.3 and mean age was 45 17 years. The normal colonoscopic finding was showed in twelve cases (18.2%). The severity of acute colitis was mild in 25 cases (25/54, 46.3%), moderate in 9 cases (9/54, 16.7%), and severe in 20 cases (20/54, 37.0%). The extent of acute colitis was as followed: involvement of one segment in 9 cases (16.7%), involvement of two or more segments in 26 cases (48.1%), pancolitis in 7 cases (13.0%), and pancolitis with involved terminal ileum in 12 cases (22.2%). In culture study, identification of Salmonella species was in 11 cases (16.7%). Salmonella species were identified in 6.0% (3/50) with stool specimen, 18.0% (9/50) with biopsy specimen, and 4.0% (2/50) with intraluminal fluid, but without statistical significance. CONCLUSION: The culture using biopsy specimens and intraluminal fluid obtained during colonoscopy may be helpful in diagnosis of cases of suggesting Salmonella-Shigella infection.
Biopsy* ; Colitis ; Colitis, Ischemic ; Colon ; Colonoscopy* ; Diagnosis ; Diarrhea* ; Enterocolitis, Pseudomembranous ; Female ; Humans ; Ileum ; Inflammatory Bowel Diseases ; Male ; Phenobarbital ; Salmonella

Ischemic colitis still remains largely underdiagnosed despite the fact that it is one of the most common disorders of the large bowel. The aims of the present study were to evaluate the variable histologic findings of ischemic colitis and to find out helpful histopathological features in diagnosis. Retrospective review of the clinical symptoms, underlying diseases, endoscopic findings of 23 patients, and the histologic features of 37 biopsies was done. We analyzed the significant pathologic features in the histologically diagnosed ischemic colitis group and compared the biopsy time between the histologically diagnosed ischemic colitis group and the non-diagnosed group. Comparison of the endoscopic biopsy time between the group that showed significant histologic features and the group that showed no significant histologic features was also done. The age of the patients ranged from 27 to 87 years. Most patients had abdominal pain, hematemesis, and melena. Endoscopic differential diagnoses included ischemic colitis, ulcerative colitis, infectious colitis, tuberculous colitis, Crohn's disease, and pseudomembranous colitis. Histologic features and diagnoses were also variable. The coagulative necrosis of mucosa and the epithelial desquamation were frequently detected in the group pathologically diagnosed as ischemic colitis. The most pathognomonic finding was coagulative necrosis of the mucosa that was almost always detected within seven days after the onset of clinical symptoms. Recognition of variable patterns of ischemic colitis in a biopsy specimen will direct the clinician to evaluate the vascular system. Early endoscopic biopsy is essential for the precise diagnosis of ischemic colitis.
Abdominal Pain ; Biopsy* ; Colitis ; Colitis, Ischemic* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Diagnosis, Differential ; Enterocolitis, Pseudomembranous ; Hematemesis ; Humans ; Melena ; Mucous Membrane ; Necrosis ; Retrospective Studies

Ischemic colitis represents most common form of gastrointestinal ischemia, usually developed in elderly or debilitated patient with a variety of underlying medical problems. The presumed etiologies are numerous. It usually presents as an acute abdominal illness with bloody diarrhea. Subacute ischemic colitis in healthy adults develops spontaneously in the absence of major vasculature occlusion, and the original insult precipitating the ischemic event usually cannot be established. Diagnosis is based on the clinical symptom, barium study, colonoscopic and histopathologic findings. Therapy and outcome are depen-dent on the severity of disease. It usually requires only medical management and is asso-ciated a good prognosis. We report a case of subacute ischemic colitis in healthy adults developed after severe watery diarrhea with literatures.
Adult ; Aged ; Barium ; Colitis, Ischemic* ; Colon ; Diagnosis ; Diarrhea* ; Humans ; Ischemia ; Prognosis

Angiodysplasia is a vascular lesion of the gut, which reveals intestinal bleeding as a major symptom. It is the cause of as much as 5~6% of the intestinal bleeding of unkown origin. Pathologically, it reveals anomalous submucosal vascular overgrowth, which is characterized by tortuous, dilated and thin-walled vessels. Because the lesion is mainly submucosal. It is hard to diagnosis with endoscopy and even in laparotpmy. Angiography has a low detection rate for angiodysplasia, but some of this typical findings are delayed excretion of dye into the venous structure around the lesion, vascular tuft in the arterial phase, and accelerated dye secretion into venous structure in the situation of arteriovenous malformation. Endoscopy, especially colonoscopy is so effective a diagnostic method as to make interventional therapy. Conjugated estrogen therapy is effective and is regarded as choice of treatment in the not-life-threatening intestinal bleeding caused by angiodysplasia. Surgery is only indicated in the case of uncontrolled bleeding. Intestinal obstruction has rarely been reported as another manifestation of intestinal angiodysplasia. Therefore pathologic definition should be confirmed, and research for pathophysiology of mucosal hypertrophy in the angiodysplasia is needed.
Angiodysplasia* ; Angiography ; Arteriovenous Malformations ; Colitis, Ischemic* ; Colonoscopy ; Diagnosis ; Endoscopy ; Estrogens ; Hemorrhage ; Hypertrophy ; Intestinal Obstruction

Ischemic colitis is recognized as the most common vascular disorder of the intestines in the elderly. Correct diagnosis is usually made after the ischemic episide is over and ischemic colitis is frequently misdiagnosed. A case is presented in which an initial diagnosis of appendicitis was made. On operation, a tumor like mass was found in ascending colon. Pathological examination revealed ischemic colitis. We report a case of ischemic colitis in ascending colon mimicking colon cancer.
Aged ; Appendicitis ; Colitis, Ischemic* ; Colon* ; Colon, Ascending* ; Colonic Neoplasms* ; Diagnosis ; Humans ; Intestines

Systemic lupus erythematosus (SLE) is a multi-system inflammatory disorder that has many symptoms. Gastrointestinal symptoms are common, while colonic involvement in the form of ischemic colitis or a colonic ulcer is rare in SLE. The differential diagnosis of ischemic proctitis with ulceration includes an infected ulcer, ulcerative colitis, Crohn's disease, solitary rectal ulcer colitis, malignant tumor, and lupus colitis. Here, we report a 22-year-old male with abdominal pain and diarrhea, who had a huge rectal ulcer that nearly obstructed the rectosigmoid junction. This turned out to be a rare gastrointestinal manifestation of lupus. He recovered after being treated with high-dose oral steroids. Our case demonstrates that a rectal ulcer is a rare, but important, complication of SLE and can be the initial clinical manifestation of the disease.
Abdominal Pain ; Colitis ; Colitis, Ischemic ; Colitis, Ulcerative ; Colon ; Crohn Disease ; Diagnosis, Differential ; Diarrhea ; Humans ; Lupus Erythematosus, Systemic ; Male ; Proctitis ; Steroids ; Ulcer ; Young Adult

Systemic lupus erythematosus (SLE) is a multi-system inflammatory disorder that has many symptoms. Gastrointestinal symptoms are common, while colonic involvement in the form of ischemic colitis or a colonic ulcer is rare in SLE. The differential diagnosis of ischemic proctitis with ulceration includes an infected ulcer, ulcerative colitis, Crohn's disease, solitary rectal ulcer colitis, malignant tumor, and lupus colitis. Here, we report a 22-year-old male with abdominal pain and diarrhea, who had a huge rectal ulcer that nearly obstructed the rectosigmoid junction. This turned out to be a rare gastrointestinal manifestation of lupus. He recovered after being treated with high-dose oral steroids. Our case demonstrates that a rectal ulcer is a rare, but important, complication of SLE and can be the initial clinical manifestation of the disease.
Abdominal Pain ; Colitis ; Colitis, Ischemic ; Colitis, Ulcerative ; Colon ; Crohn Disease ; Diagnosis, Differential ; Diarrhea ; Humans ; Lupus Erythematosus, Systemic ; Male ; Proctitis ; Steroids ; Ulcer ; Young Adult

Ischemic colitis is a frequent disorder of large bowel in elderly persons or in debilitated patients with a variable underlying medical problems. Ischemic colitis may result from alterations in the systemic circulation or anatomic or functional changes in the local mesenteric vasculature. In most cases, no specific cause for the ischemic colitis is identified. Cases of ischemic colitis after enema for bowel cleansing have been rarely reported, but there has been no case report after normal saline enema. We report a case of ischemic colitis in a 72-year old patient with well-controlled hypertension, presenting as bloody diarrhea which developed after normal saline enema for preoperative bowel cleansing.
Aged ; Colitis, Ischemic/*diagnosis ; Diarrhea/*diagnosis ; *Enema ; Hemorrhage/diagnosis ; Humans ; Male ; Sigmoidoscopy ; Sodium Chloride/*administration & dosage ; Tomography, X-Ray Computed