A Case of Gangrenous-Type Ishemic Colitis

Kimimasa Ikeda, Nobuhiro Shibata, Sadao Noguchi, Naoki Fujimoto, Takao Aikawa, Naozumi Higaki, Masamitsu Tamai*

Department of Surgery and Department of Pathology*, Nishinomiya Municipal Central Hospital

We report a case of gangrenous-type ischemic colitis involving the bowel from the cecum to the sigmoid colon. The patient, a 59-year-old woman, was admitted to our hospital complaining of abdominal pain and vomiting. The next day, rebound tenderness appeared on abdominal examination, and an emergency laparotomy was carried out. consecutive necrosis of the bowel from the cecum to the sigmoid colon was discovered. Under the diagnosis of gangrenous-type ischemic colitis, subtotal colectomy and exteriorization of both ends were performed resulting in her survival. In 49 cases of gangrenous-type ischemic colitis in the Japanese literature, the patients' ages ranged from 34 to 90 years (mean 70.2) with the majority in the seventh, eighth and ninth decades. There were 21 males and 22 females (6 unknown). The descending and sigmoid colon were most frequently involved. The mortality of 38 cases (11 unknown) was 44.7%, and. in 36 resected cases, the mortality was 41.7%. This indicates poor prognosis of gangrenous-type ischemic colitis. The only therapy for survival is resection of the gangrenous area, and wide excision should be performed with observation of the intestinal mucosa of both ends.

Key words
ischemic colitis, gangrenous-type ischemic colitis

Reprint requests
Kimimasa Ikeda Department of Surgery, Nishinomiya Municipal Central Hospital
8-24 Hayashida-cho, Nishinomiya City, 663 JAPAN

Accepted
April 14, 1993

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