| [ Summary ] |
Ischemic colitis is a common form of ischemic bowel lesions. We describe the clinical characteristics of ischemic colitis based on the severity of the condition (transient, stricture and gangrenous types). Based on the clinical course, ischemic colitis is classified into 3 types transient, stricture, and gangrenous types. The transient type is the most common variety. The stricture type is observed in a few patients(approximately 10 %), and the gangrenous type is rare in Japan. The transient type affects most individuals in their 50s and 60s, whereas the stricture and gangrenous types tend to affect elderly individuals. Although ischemic colitis develops from various vascular and intestinal factors, the vascular factors become predominant over the intestinal factors as they differentiate stricture type and also gangrenous type from transient type. During the acute phase of the disease in patients with the transient and stricture type, barium enema studies show edema and the characteristic thumbprinting appearance, and colonoscopy shows erythema, edema, and longitudinal mucosal ulcers. In contrast, colonoscopy in patients with the gangrenous type shows dark red-colored mucosa or a hematoma-like mucosa.Additionally, we have outlined the clinical characteristics of patients presenting with ischemic colitis including those showing a younger age at onset (age < 40 years), the presence of right-sided colitis, and recurrence. Finally, we have described infectious colitis, which shows clinical features similar to ischemic colitis. |