| Theme |
Differential diagnosis for common enterocolitis, especially in endoscopic findings |
| Title |
Ischemic colitis |
| Author |
Kazuhiro Kashiwagi |
Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University |
| Author |
Naoki Hosoe |
Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University |
| Author |
Makoto Naganuma |
Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University |
| Author |
Nagamu Inoue |
Center for Preventive Medicine, School of Medicine, Keio University |
| Author |
Yasushi Iwao |
Center for Preventive Medicine, School of Medicine, Keio University |
| Author |
Akihiro Yamaguchi |
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Keio University |
| Author |
Takanori Kanai |
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Keio University |
| Author |
Hiroyuki Imaeda |
Department of General Internal Medicine, Saitama Medical University |
| Author |
Haruhiko Ogata |
Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University |
| [ Summary ] |
Colonic ischemia is defined as a condition with lesions which are treatable. Localized ischemia is due to microcirculatory disturbances without occlusion of the main abdominal artery. Bowel habits and arteriosclerosis are thought to be leading causes of ischemic colitis. Colonic ischemia is diagnosed through blood tests, abdominal computed tomography, colonoscopy and/or barium enemas. In the acute stage of ischemic colitis, colonoscopy is useful for diagnosis. Those images show vasodilatation, redness, edema, scale-pattern and longitudinal ulcers of the colonic mucosa. It's also important to discriminate between ischemic colitis and acute colitis with bleeding, including antibiotic-induced hemorrhagic colitis, infectious colitis, CD, and collagenous colitis with clinical symptoms, to determine clinical course and, especially, to verify colonoscopic findings. In most cases of ischemic colitis, conservative treatment is needed to rest the colon, except for gangrenous forms, for which the primary treatment is surgical resection. |