A Comparison of clinical characteristics between medically-treated patients and surgically-treated patients with ischemic colitis

Abstract

Background/aims: Ischemic colitis (IC) is usually a self-limiting disease. But, it can cause necrosis that requires urgent surgical treatment. We sought to evaluate clinical difference in IC patients between medical and surgical treatment groups, and to identify prognostic factors for adverse outcomes.

Methods: We conducted a retrospective analysis of clinical characteristics in patients with IC treated in Chonnam National University Hospital between May 2001 and April 2010. A total of 81 patients with IC were enrolled. We classified the patients into two groups-a medical treatment group and a surgical treatment group-and evaluated their clinical features, treatment outcomes and mortality.

Results: Absence of hematochezia, vomiting, abdominal tenderness, abdominal rebound tenderness, heart rate over 90 beats/min, systolic blood pressure less than 100 mm Hg, hyponatremia and increased LDH or serum creatinine level were observed more frequently in surgically-treated patients (p<0.05). Most cases in the medically-treated group resolved without complications (98.3%). But, about half of the cases (52.4%) of the surgically-treated group resolved and the mortality rate was 47.6%.

Conclusions: In patients with ischemic colitis, several clinical factors are associated with surgical treatment. Although IC is often selflimited, our data suggests that special attention and aggressive therapy is warranted in treating these patients.

Keywords: Clinical factor; Hematochezia; Ischemic colitis; Rebound tenderness; Surgery.