Prognostic Outcome of Patients with Total Colonic Ischemia

DOI 4 Citations 19 References
  • Hirata Keiji
    Department of Surgery 1, University of Occupational and Environmental Health
  • Onitsuka Koji
    Department of Surgery 1, University of Occupational and Environmental Health
  • Shibao Kazunori
    Department of Surgery 1, University of Occupational and Environmental Health
  • Okazaki Keisuke
    Department of Surgery 1, University of Occupational and Environmental Health
  • Tsurudome Yosuke
    Department of Surgery 1, University of Occupational and Environmental Health
  • Higure Aiichiro
    Department of Surgery 1, University of Occupational and Environmental Health
  • Nakayama Yoshifumi
    Department of Surgery 1, University of Occupational and Environmental Health
  • Okamoto Koji
    Department of Surgery 1, University of Occupational and Environmental Health
  • Konishi Tetsumi
    Department of Surgery 1, University of Occupational and Environmental Health
  • Nagata Naoki
    Department of Surgery 1, University of Occupational and Environmental Health
  • Kuroda Yusuke
    Department of Surgery 1, University of Occupational and Environmental Health
  • Itoh Hideaki
    Department of Surgery 1, University of Occupational and Environmental Health

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Other Title
  • 壊死型虚血性大腸炎における全結腸壊死と限局性壊死の比較検討

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Abstract

PURPOSE: We determined the prognostic outcome of patients with gangrenous ischemic colitis, compar ing patients with segmental disease and those with total colonic ischemia. METHODS: Patients with gangrenous ischemic colitis were investigated and reviewed for demographics, symptoms, diagnosis, treat ment, and prognosis, with data taken from cases documented over the last 10 years in Japan. RESULTS: We identified 119 patients and subclassified them into those with segmental ischemic colitis and total colonic ischemia. Mean age was 70.1 years; 50 of the 113 were men. Ischemic colitis developed during the hospital-ization of 26 of 119 during admission for an unrelated illness. Diagnosis of ischemic colitis was made preoperatively in 24 and in the operating room in the remainder. Total mortality was 31.1%. Ninety four of the 119 patients had segmental colitis, with a mortality of 17.9%, and 25 total colonic ischemia, with a mortality of 72.0%, (p<0.001, X2 test). CONCLUSION: Although the prognosis for gangrenous ischemic colitis has improved slightly in the last decade, high mortality remains the hallmark in total colonic ischemia, which carries a worse prognosis than segmental colonic ischemia.

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