Korean J Gastrointest Endosc.  2002 Dec;25(6):480-483.

A Case of Ischemic Colitis with Massive Bleeding

• Kim SM
• Park YS
• Jung IS
• Yang JS
• Seo YS
• Joo YH
• Kim TH
• Cho YJ
• Han JK
• Joo JE

Abstract

Ischemic colitis generally develops in the elderly patients with concomitant cardiovascular condition, diabetes mellitus, and renal insufficiency. This disease predominently occurs in the left colon, particularly splenic flexure and sigmoid colon. The most frequent symptoms include abdominal pain, diarrhea, alteration in bowel functions and hematochezia. Blood loss is usually minimal in most patients. Herein, we report a case of ischemic colitis which developed on ascending colon with massive bleeding. A 48-year-old man was admitted because of massive lower gastrointestinal bleeding for 7 days. He has underwent hemodialysis for thirteen years. Colonoscopy showed a circular ulcer on the ascending colon with partial stenosis and mass-like oozing lesion distal to the stenotic area. We performed right hemi-colectomy. Grossly, colon showed shallow ulceration and congested ileocecal valve coated with hemorrhage. Microscopically, ulcer bed showed thickened and fibrotic submucosa which had nearly obliterated atherosclerotic vessels.

Keyword

Ischemic colitis; Ascending colon; Massive bleeding

MeSH Terms

Abdominal Pain
Aged
Colitis, Ischemic*
Colon
Colon, Ascending
Colon, Sigmoid
Colon, Transverse
Colonoscopy
Constriction, Pathologic
Diabetes Mellitus
Diarrhea
Estrogens, Conjugated (USP)
Gastrointestinal Hemorrhage
Hemorrhage*
Humans
Ileocecal Valve
Middle Aged
Renal Dialysis
Renal Insufficiency
Ulcer
Estrogens, Conjugated (USP)