Successful Treatment of an Elderly Patient with Gangrenous Ischemic Colitis

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 26; no. 1; pp. 77 - 80
• Main Authors: Kenmochi, Kunihiko, So, Hironobu, Hamada, Shigeru, Shimokobe, Tomohisa, Sasaki, Ei, Nakamura, Katsumi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 2006
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem1993.26.77

A 90-year-old woman was admitted to our hospital because of bloody stools and upper abdominal pain. Though laboratory examinations indicated relatively non-severe conditions, limited peritoneal signs in the left upper quadrant were observed. The segmental wall thickness of the left part of the transverse colon and ascites storage revealed by CT scan suggested mesenteric ischemia, and emergency surgery was performed. The transverse colon had atrophied over a region of about 20cm, although the corresponding mesenterium, including the blood vessels, appeared normal. These findings were judged irreversible, and a Hartmann's operation was recommended. Pathological examination showed mucosal necrosis and ischemic changes in the wall, but no thrombi in the main arteries of the mesenteric specimen were observed. Treatment was successful thanks to the early diagnosis and surgical treatment, and the patient was discharged on postoperative day 40.