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Ischemic Colitis of the Transverse Colon, Report of a Case M. Enomoto 1 , J. Yamada 1 , Y. Yada 1 , K. Sasabe 1 , N. Takakura 1 , Y. Kitayama 1 , T. Iwado 1 , K. Matsuda 1 1Matsuda Surgical Hospital pp.489-495
Published Date 1979/4/25
DOI https://doi.org/10.11477/mf.1403107656
  • Abstract
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 A study has been made of a case of ischemic colitis. We have arrived at the diagnosis after due retrospective investigation. Initially it was diagnosed as “non-specific ulcer” based on the pathologic examination after excision.

 The patient, a man aged 49, had a previous history of arrhythmia and hypotesion. He was constipated before the onset of pain. After eating evening meal, he had a sudden bout of pain in the left-hand side of the abdomen in addition to vomiting. The initial examination showed tenderness and resistance in the LUQ. BSD was accelerated with leucocytosis. ECG showed atrial flimmern. On the 10 th day of admission, complaints and objective findings disappeared. In the meantime, transient melena was seen on the fifth day, and barium enema on the sixth day showed about nine cm long thumb printing in the transverse colon in the side of the splenic flexure. Endoscopy on the ninth day of admission revealed there circumferentially reddening, edema, multiple erosions and shallow ulcer. Biopsical diagnosis was “non-specific ulcer.” Peroral X-ray examination of the digestive tract performed on the 16 th day showed more manifest tubular narrowing. Partial colectomy done on the 29 th day revealed a round ulcer on the posterior wall on the side of the mesentery attachment. Histologically, it was an ulcer Ul-Ⅱ showing distinct granulation and regeneration of the blood vessels. Pathologic diagnosis was “non-specific ulcer.”

 The present case can be interpreted as a series of ischemic changes by (1) a preliminary stage of signs and symptoms such as arrhythmia, hypotension, constipation and over-eating, (2) peculiar clinical course suddenly developed by abdominal pain with transient and characterized by the disappearance of complaints and objective findings, (3) peculiar barium enema findings represented by thumb-printing or pseudo tumors, and (4) pathologic findings of “non-specific ulcer.” We have thus arrived at a diagnosis of non-occulusive ischemic colitis.


Copyright © 1979, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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