A Report of Three Cases with Transient Ischemic Colitis

Chung, Eul Soon; Lee, Sang Jong; Kim, Hyang; Park, Chang Young; Kim, Kyung Soo; Hwang, Kie Eun; Pyeon, Yoo Jang; Jang, Nam Soo; You, Jong Hyun; Jun, Woo Kue; Park, Jung Ro

Abstract

Ischemic colitis is a well-known disease entity. It is caused by inadequate tissue perfusion secondary to either occlusive or nonocclusive conditions which result in relative hypoxia of the colon. Mostly the cl.inical course is transient and self-limiting, but less commonly it may show fulminant transmural necrosis necessitating surgical manipulation. Recently, we have experienced three patients who complained of acute cramping abdominal pain and bloody diarrhea. On colonoscopy, the descending, sigmoid, and rectosigmiod colon showed hyperemic mucosae with petechiae alternating with pale area, the margins of which were sharply demarcated. Well-defined superficial ulceration was also present. Microscopically, the colonic mucosae of three patients revealed congestion, hemorrhage, hemosiderin-laden macrophages, coagulation necrosis, and fibrinous thrombus in the lamina propria, which were compatable with ischemic colitis of acute and/or healing phase. After conservative treatment with antibiotics and electrolyte correction for two weeks each, the colonic mucosae were nearly completely healed on follow-up examination. Above clinical, colonoscopic and histopathologic features were well compatible with transient ischemic colitis in all patients. We report three cases of transient ischemic colitis those were successfully treated with conservative management.