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Pathomorphologic Study of Ischemic Colitis A. Iwashita 1 , M. Iida 2 1The Second Department of Pathology, Faculty of Medicine, Kyushu University 2The Second Department of Internal Medicine, Faculty of Medicine, Kyushu University pp.245-257
Published Date 1981/3/25
DOI https://doi.org/10.11477/mf.1403107971
  • Abstract
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 Ischemic colitis is now well recognized as an established clinical entity. In this paper, 16 patients with this disease were studied pathomorphologically. Sourse of pathologic materials was surgical resection in ten and endoscopic biopsy in six.

 In four cases with this disease in acute phase macroscopic changes were diffuse mucosal homorrhage and irregular open ulcers, Ul-Ⅰ and/or Ul-Ⅱ, having tendency to longitudinal situation and to association with pseudomembrane. The histologic features of these cases consisted of fresh mucosal hemorrhage, degeneration and necrosis of glandular epithelium, open ulcer, and marked submucosal thickening due to prominent edema, hemorrhage, congestion and neutrophilic infiltration.

 Six cases showing ischemic stricture of the bowel presented the lesion made up of one and/or three, long, longitudinal, linear or zonal ulcers, open or healed, along the teniae coli. More than two longitudinal ulcers were characteristic of ischemic colitis in chronic phase. The microscopic appearances were composed of five main pictures as follows; 1) Ulcers of Ul-Ⅱ, 2) Open ulcers floored with vascular granulation tissue characterized by swollen endothelial cells of the capillaries, 3) Prominent fibromusculosis and fibrosis in the submucosa adjacent to the healing ulcers, 4) Presence of many hemosiderin-laden macrophages scattered through the whole thickness of the colon, 5) Slight inflammatory infiltrate consisting mainly of lymphocytes and plasma cells. Among these findings, presence of many hemosiderin-laden macrophages is considered as of particular diagnostic importance.


Copyright © 1981, Igaku-Shoin Ltd. All rights reserved.

基本情報

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

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