Ischemic Colitis and Enteritis Kiyonori Kobayashi 1 , Tomoe Katsumata 1 , Masahiro Igarashi 1 1Department of Gastroenterology, Kitasato University East Hospital Keyword: 虚血性大腸炎 , 虚血性小腸炎 , 大腸内視鏡 , 消化管造影 , 治療方針 pp.599-606
Published Date 2005/4/25
DOI https://doi.org/10.11477/mf.1403100077
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Ischemic colitis is a representative intestinal disease which causes anal bleeding. In severe cases, sometimes progressing to gangrenous or stricturing type, early estimation of clinical severity is necessary for selecting appropriate treatments. In cases that have progressed to gangrene or the stricturing type, the colonoscopic picture often demonstrates marked congestion and edema with necrosis of colonic mucosa in the early phase of the disease. Longitudinal and irregular-shaped deep ulcers with clear margin are also seen in the lesion. The most characteristic colonoscopic findings of gangrenous type are multiple dome-like mucosal elevations with grayish-green color. As for the treatment, a transient type can be treated conservatively, but a gangrenous type requires an emergency operation. In addition, with the stricturing type, there are times when the intestinal stenosis improves during the course of the disease. Therefore, the indication for surgical operation should be judged by radiographic and colonoscopic findings examined over one month after onset.

 Ischemic enteritis is rare and only occasionally dose it cause anal bleeding. Most of the lesions associated with ischemic enteritis progress to tubular stenosis with a circumferential ulcer, and require surgical intervention.

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