The spectrum of ischaemic colitis

Eur J Gastroenterol Hepatol. 1999 Mar;11(3):295-303. doi: 10.1097/00042737-199903000-00014.


Objective: Ischaemic colitis is generally considered a disease of the elderly with considerable cardiovascular morbidity. We aimed to determine the effect of age, co-morbidity and clinical presentation on type, severity and anatomy of involvement of ischaemic colitis. Thrombophilic tendencies have been poorly studied and coagulation status was performed in available patients.

Design: Retrospective case identification with prospective follow-up.

Setting: University teaching hospital.

Participants: Twenty-four patients (16 female, mean age 64 years) with ischaemic colitis.

Interventions: Blood analysis for clotting tendencies.

Main outcome measures: Operation rates, death rates and frequency of clotting abnormalities.

Results: Five patients (21%) were below the age of 45, and seven of the 24 had died by the time of follow-up. Four had died of ischaemic colitis during the acute episode. The four patients that died of ischaemic colitis had a more extensive and more severe type of disease and presented with worse clinical features. The main predisposing factors were ischaemic heart disease in 12 (50%) and malignancy in five (21%). Six of the 24 cases (25%) had right-sided lesions and this conferred a good prognosis. Shock, peritonism, extensive disease and uncontrolled atrial fibrillation were all poor prognostic factors. Clotting factor abnormalities could be detected in three of nine patients despite a time lapse between assay and episode of ischaemic colitis.

Conclusions: Ischaemic colitis appears to have two patterns of severity. Anatomical distribution is more variable than a developmental explanation of the vascular supply. Clotting abnormalities may be detected in a minority even on retrospective testing.

MeSH terms

  • Acute Disease
  • Age Factors
  • Aged
  • Atrial Fibrillation / complications
  • Blood Coagulation Disorders / complications
  • Blood Coagulation Factors / analysis
  • Cause of Death
  • Colitis, Ischemic / classification
  • Colitis, Ischemic / complications
  • Colitis, Ischemic / pathology
  • Colitis, Ischemic / physiopathology*
  • Colitis, Ischemic / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / complications
  • Neoplasms / complications
  • Peritonitis / complications
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors
  • Shock / complications
  • Survival Rate
  • Thrombosis / complications


  • Blood Coagulation Factors