Ischemic Colitis, Report of a Case Tokiaki Toyohara 1 , Fukuji Mochizuki 1 , Shoichiro Ito 1 , Takashi Ikeda 1 , Naotaka Fujita 1 , Shigeki Lee 1 , Masahiro Nagano 1 , Akira Funada 2 1Institute of Gastroenterology and Internal Medicine, Sendai City Medical Center 2Funada Hospital pp.1243-1248
Published Date 1986/11/25
DOI https://doi.org/10.11477/mf.1403110145
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 A 61 year-old woman visited Funada Hospital complaining of sudden onset of burning sensation in the lower abdomen and melena. Barium enema study performed next day showed irregular barium flecks and rigidity of the sigmoid colon. Thumb-printing, sacculation and tubular narrowing, however, were not found. Endoscopic examination on the 7 th day after the onset showed edematous mucosa surrounding the shallow ulceration of sub-circular form with bleeding areas and notches in the base.

 She was admitted to Sendai City Medical Center Hospital on the 16 th day after the onset in order to have further examinations. The second endoscopic examination at about four weeks after the onset showed predominantly edematous mucosa (like tumor change) surrounding the shallow ulceration with irregular white coating and red patches, and the third at about six weeks after the onset showed non-swollen converging folds around the shallow ulceration with monotonous white coating.

 Histological study of the biopsy specimen showed decreasing of goblet cells, hemorrhage, congestion and invasion of eosinophilic substance in mucosal layer. Since the possibility of malignancy was not completely ruled out, she underwent an operation on the 45 th day after the onset.

 The resected specimen showed a sub-circular ulceration of 2. 4 X 1. 3 cm in size with converging folds in the sigmoid colon. Histological examination revealed Ul-I ulceration and predominantly fibrous and vascular granulation tissues in the ulcer base with partially regenerative epithelium surrounding ulceration. Iron staining was positive in the ulcer base. Based on these histological findings, the patient was finally diagnosed as having had transient ischemic colitis.

Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.


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