Reevaluation of clinical features of ischemic colitis. Analysis of 68 consecutive cases diagnosed by early colonoscopy.

BACKGROUND: Ischemic colitis (IC) is generally considered a disease of elderly patients who have associated diseases. The aim of the present study was to reevaluate the clinical features of IC.

METHODS: We retrospectively analyzed the clinical characteristics, background, and endoscopic and histologic changes in 68 consecutive patients (16 men and 52 women) with this disease diagnosed by early colonoscopy.

RESULTS: The patients' age ranged from 22 to 98 years (mean, 55 years). Twenty-three patients (34%, including 19 women) were less than 50 years of age. The classical predisposing factors were not discernible in patients younger than 50. Chronic constipation and prior history of abdominal surgery were common in both young and old patients. Early colonoscopy (especially by the 3rd day from onset) showed endoscopic and histologic findings consistent with the characteristics of IC.

CONCLUSIONS: IC is not limited only to the elderly, and it should be considered in the differential diagnosis of colitis with melena in younger patients, especially females, who do not have any predisposing factors. Chronic constipation and prior history of abdominal surgery were commonly associated in both young and old patients. Early colonoscopy, especially by the 3rd day from the clinical onset, is essential for the accurate diagnosis of IC.