Ischaemic colitis--a clinical study of seven patients with special emphasis on diagnostic problems

Abstract

Ischaemic colitis is a relatively rare but well-defined disease entity. It is associated with high mortality rate if early diagnosis and adequate surgical treatment is not accomplished. The aim of the present study was a clinical analysis of 7 patients with the verified ischaemic colitis. The delay from admission to the correct diagnosis was 8 days on the average (range 2-15 days). The reasons for delayed diagnosis included suspicion of diverticulitis, Crohn's disease and bowel obstruction as well as poor general condition in one case because of which early colonoscopy was not done. It is concluded that in patients with abdominal pain, rectal bleeding and diarrhoea associated with typical clinical findings, ischaemic colitis should be suspected. This suspicion should be followed by early colonoscopy to detect the gangrenous form of the disease as early as possible. Instant laparotomy and excision of the affected bowel is necessary for cure in these patients.