Materiały źródłowe

• #1 Prevalence and predictive value of sarcopenia in hospitalized patients with ischemic colitis | Scientific Reports

  https://www.nature.com/articles/s41598-024-65243-6

  Ischemic colitis (IC) occurs owing to blood flow that is insufficient to maintain the metabolic function of colonocytes and it accounts for 75% of intestinal ischemia. […] Additionally, a population-based cohort study in the United States found that the annual incidence of IC was 16.3 per 100,000 person-years, and it has increased over the past three decades. […] The incidence of IC tends to increase with age, and is associated with various medical conditions, surgical history, and drug usage. […] Identifying poor prognostic factors for IC and determining early intervention would help to improve the outcomes of IC treatment. […] The prevalence of sarcopenia in hospitalized patients with IC differed according to whether it was defined as SMA/BMI (49.3%) or SMA/height2 (34.7%). […] The prognosis of patients with sarcopenia was worse in terms of IC. […] Moreover, sarcopenia was identified as an independent predictor of mortality or surgical intervention. […] These findings suggest the need for meticulous monitoring, prompt medical treatment, and timely surgical consultation, particularly for patients with IC and sarcopenia.

• #2 Ischemic colitis involving the right-side colon: clinical case report and diagnostic considerations – Huang – Journal of Xiangya Medicine

  https://jxym.amegroups.org/article/view/8132/html

  Ischemic colitis is the most common form of gastrointestinal ischemia. […] The incidence of ischemic colitis is about 15.6/100,000 person-year. […] Most colonic ischemia occurs in the left-side, they usually have a good prognosis. But when lesion involves the right-side colon, patients may have a higher surgery rate and in-hospital mortality. […] ACG Clinical Guideline considers CT the main technique for the non-invasive diagnosis of ischemic colitis. […] When colonoscopy is difficult to perform, risk factor analysis can be helpful in clinical diagnosis. […] Patients with ischemic colitis usually have identifiable risk factors. […] In this case, we inferred that the rash may also be a risk factor. […] Diabetes is also a potential risk factor. […] Early diagnosis of ischemic colitis has always been a difficult problem, most of the challenges come from its unspecific clinical manifestations.

• #3 Colitis, Ischemic | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117214/1.1/Colitis__Ischemic

  Ischemic colitis (IC) results from decreased blood flow to the colon with resultant inflammation and tissue damage. […] More common in women (5776%particularly after age 69 years) (1) […] Evidence of IC is seen in 1 of every 100 endoscopies. […] Incidence Approximately 23 cases per 100,000 person-years (ranges from 4.5 to 44) in the general population (may be underestimated due to nonspecific clinical manifestations) […] Prevalence 19 cases per 100,000 in the general population.

• #4 Systematic review: the epidemiology of ischaemic colitis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/15043513/

  Ischaemic colitis has been associated with co-morbid conditions, medications, vascular surgery and advanced age in case reports and case series. […] Few data exist on the baseline incidence in the general population or on the increased risk imposed by these risk factors. […] To systematically review the literature regarding the incidence, prevalence and risk factors for ischaemic colitis. […] Four studies were identified that reported the general population incidence and four that reported the disease-specific population incidence. The incidence of ischaemic colitis in general populations ranged from 4.5 to 44 cases per 100 000 person-years. The risk was increased two- to four-fold by either prevalent irritable bowel syndrome or chronic obstructive pulmonary disease. The risk was also increased in females and in subjects of 65 years and older. […] Ischaemic colitis is uncommon in the general population. The effect sizes of the most commonly reported risk factors have not been adequately quantified in population-based studies.

• #5 A Population-Based Study of Incidence, Risk Factors, Clinical Spectrum, and Outcomes of Ischemic Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4326614/

  Little is known about progression of ischemic colitis (IC) among unselected patients. We aimed to estimate the incidence, risk factors, and natural history of IC in a population-based cohort in Olmsted County, Minnesota. The age- and sex-adjusted incidence rates of IC nearly quadrupled, from 6.1 cases/100,000 person-years in 1976-1980 to 22.9/100,000 in 2005-2009. The incidence of IC increased over the past 3 decades in a population-based cohort in Minnesota. There is a paucity of epidemiological data derived from review of actual patient medical records, especially on the incidence and risk factors of IC in the general population. The overall annual incidence of IC between 1976 and 2009 was 16 cases per 100,000 person-years. The age-and sex- adjusted incidence of IC nearly quadrupled over the course of 34 years, from 6.1 cases per 100,000 person-years in 1976-1980 to 22.9 per 100,000 person-years in 2005-2009. The rapid rise in incidence of IC over 34 years may have been due to a number of factors, including increasing life expectancy for patients with underlying predisposing chronic diseases, especially atherosclerotic diseases. In our population, IBS was not a risk factor for IC. The five-year survival among IC cases was 58% as compared to 90% in the Olmsted County controls. Age older than 50 years, right-sided colonic involvement, small bowel involvement, COPD and male gender were all independent predictors of mortality.

• #6 Bowel Ischaemia | Doctor

  https://patient.info/doctor/bowel-ischaemia

  Ischaemic colitis is caused by a compromise of the blood circulation supplying the colon. […] How common is ischaemic colitis? (Epidemiology) The incidence of ischaemic colitis rose from 6.1 cases/100000 person-years in 1976-80 to 22.9/100000 in 2005-09. Many mild cases may go unreported. […] Because the most common cause is atheroma of the mesenteric vessels it is mainly a disease of the elderly and is rare before the age of 60. […] The average age for diagnosis is 70. The incidence is likely to increase with the increasing age of the population. The condition is, however, by no means unknown in younger age groups, due to non-cardiovascular causes such as cocaine abuse.

• #7 A Population-Based Study of Incidence, Risk Factors, Clinical Spectrum, and Outcomes of Ischemic Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4326614/

  Little is known about progression of ischemic colitis (IC) among unselected patients. We aimed to estimate the incidence, risk factors, and natural history of IC in a population-based cohort in Olmsted County, Minnesota. The age- and sex-adjusted incidence rates of IC nearly quadrupled, from 6.1 cases/100,000 person-years in 1976-1980 to 22.9/100,000 in 2005-2009. The incidence of IC increased over the past 3 decades in a population-based cohort in Minnesota. There is a paucity of epidemiological data derived from review of actual patient medical records, especially on the incidence and risk factors of IC in the general population. The overall annual incidence of IC between 1976 and 2009 was 16 cases per 100,000 person-years. The age-and sex- adjusted incidence of IC nearly quadrupled over the course of 34 years, from 6.1 cases per 100,000 person-years in 1976-1980 to 22.9 per 100,000 person-years in 2005-2009. The rapid rise in incidence of IC over 34 years may have been due to a number of factors, including increasing life expectancy for patients with underlying predisposing chronic diseases, especially atherosclerotic diseases. In our population, IBS was not a risk factor for IC. The five-year survival among IC cases was 58% as compared to 90% in the Olmsted County controls. Age older than 50 years, right-sided colonic involvement, small bowel involvement, COPD and male gender were all independent predictors of mortality.

• #8 Ischemic colitis caused increased early and delayed mortality | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-018-0193-2

  Ischemic colitis (IC) refers to the inflammation of the colon secondary to vascular insufficiency and ischemia. IC is the most common type of intestinal ischemia with an annual incidence of 15.6 to 17.7 per 100,000. […] The overall mortality rate was 29% (18/63). Six patients (50%) of those operated died. […] Ischemic colitis causes increased mortality rates both in the immediate and late postoperative course. The disease process needs a better understanding in order to tailor the appropriate treatment, especially surgical intervention for those patients who require it.

• #9 Ischemic colitis involving the right-side colon: clinical case report and diagnostic considerations – Huang – Journal of Xiangya Medicine

  https://jxym.amegroups.org/article/view/8132/html

  Ischemic colitis is the most common form of gastrointestinal ischemia. […] The incidence of ischemic colitis is about 15.6/100,000 person-year. […] Most colonic ischemia occurs in the left-side, they usually have a good prognosis. But when lesion involves the right-side colon, patients may have a higher surgery rate and in-hospital mortality. […] ACG Clinical Guideline considers CT the main technique for the non-invasive diagnosis of ischemic colitis. […] When colonoscopy is difficult to perform, risk factor analysis can be helpful in clinical diagnosis. […] Patients with ischemic colitis usually have identifiable risk factors. […] In this case, we inferred that the rash may also be a risk factor. […] Diabetes is also a potential risk factor. […] Early diagnosis of ischemic colitis has always been a difficult problem, most of the challenges come from its unspecific clinical manifestations.

• #10 Ischemic colitis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Ischemic_colitis_epidemiology_and_demographics

  Ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia. Ischemic colitis is responsible for about 50 out of 100,000 hospital admissions, and is seen on about 100 in 100,000 endoscopies. […] The exact incidence of ischemic colitis is difficult to estimate, as many patients with mild ischemia may not seek medical attention. Ischemic colitis is responsible for about 50 out of 100,000 hospital admissions, and is seen on about 100 in 100,000 endoscopies. […] Ischemic colitis is a disease of the elderly, with greater than 90% of cases occurring in people over the age of 60. […] Females are more likely to suffer from ischemic colitis than are males.

• #11 Colitis, Ischemic | 5-Minute Clinical Consult

  https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117214/1.1/Colitis__Ischemic

  Ischemic colitis (IC) results from decreased blood flow to the colon with resultant inflammation and tissue damage. […] More common in women (5776%particularly after age 69 years) (1) […] Evidence of IC is seen in 1 of every 100 endoscopies. […] Incidence Approximately 23 cases per 100,000 person-years (ranges from 4.5 to 44) in the general population (may be underestimated due to nonspecific clinical manifestations) […] Prevalence 19 cases per 100,000 in the general population.

• #12

  https://journals.lww.com/ajg/fulltext/2004/10001/background_epidemiology_of_ischemic_colitis__335.332.aspx

  A recent study reported a 4-fold increased rate of ischemic colitis (IC) among patients with irritable bowel syndrome (IBS) compared to a control group without IBS. The rate of IC in that control group was 40 per 100,000 person-years. […] The prevalence of IC identified from the screening colonoscopy was 49.6 per 100,000 persons (2 in 4,033). […] The prevalence of IC identified from the DC was 329.1 per 100,000 persons (853 in 259,225); 72.0% of which were female. […] The cross-sectional analysis revealed an annual population prevalence of IC of 42.1, 39.4, 41.6, 49.7 per 100,000 persons from 1999 to 2002, respectively. […] In this population based study, we found a consistent annual prevalence of IC to be about 40 per 100,000 persons. Among those that had a screening colonoscopy, we found a prevalence of IC equal to 49.6 per 100,000 persons, indicating a relatively high occurrence of IC even among patients not seeking care for GI-related symptoms.

• #13

  https://journals.lww.com/ajg/fulltext/2004/10001/background_epidemiology_of_ischemic_colitis__335.332.aspx

  A recent study reported a 4-fold increased rate of ischemic colitis (IC) among patients with irritable bowel syndrome (IBS) compared to a control group without IBS. The rate of IC in that control group was 40 per 100,000 person-years. […] The prevalence of IC identified from the screening colonoscopy was 49.6 per 100,000 persons (2 in 4,033). […] The prevalence of IC identified from the DC was 329.1 per 100,000 persons (853 in 259,225); 72.0% of which were female. […] The cross-sectional analysis revealed an annual population prevalence of IC of 42.1, 39.4, 41.6, 49.7 per 100,000 persons from 1999 to 2002, respectively. […] In this population based study, we found a consistent annual prevalence of IC to be about 40 per 100,000 persons. Among those that had a screening colonoscopy, we found a prevalence of IC equal to 49.6 per 100,000 persons, indicating a relatively high occurrence of IC even among patients not seeking care for GI-related symptoms.

• #14 Ischemic colitis – Wikipedia

  https://en.wikipedia.org/wiki/Ischemic_colitis

  The exact incidence of ischemic colitis is difficult to estimate, as many patients with mild ischemia may not seek medical attention. Ischemic colitis is responsible for about 1 in 2000 hospital admissions and is seen on about 1 in 100 endoscopies. Men and women are affected equally; ischemic colitis is a disease of the elderly, with more than 90% of cases occurring in people over the age of 60.

• #15 Ischemic colitis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Ischemic_colitis_epidemiology_and_demographics

  Ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia. Ischemic colitis is responsible for about 50 out of 100,000 hospital admissions, and is seen on about 100 in 100,000 endoscopies. […] The exact incidence of ischemic colitis is difficult to estimate, as many patients with mild ischemia may not seek medical attention. Ischemic colitis is responsible for about 50 out of 100,000 hospital admissions, and is seen on about 100 in 100,000 endoscopies. […] Ischemic colitis is a disease of the elderly, with greater than 90% of cases occurring in people over the age of 60. […] Females are more likely to suffer from ischemic colitis than are males.

• #16 Ischemic colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ischaemic-colitis?ref=binfind.com%2Fweb

  Ischemic bowel is typically a disease of the elderly (age 60 years) where atherosclerotic disease or low flow states are usually the cause. It is rare in younger individuals, where it is more likely to be related to vasculitis or hypercoagulable states. […] Prognosis is variable: resolution without ongoing complications ~50%, persistent colitis ~20%, ischemic stricture ~10%, gangrene or perforation ~20%. […] Occlusive mesenteric infarction (embolus or thrombosis) has a high mortality rate (~90%) compared to non-occlusive ischemia (~10%).

• #17 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] Older patients with risk factors for atherosclerosis are at especially high risk for developing colon ischemia. […] Overall mortality: 4-12% […] Recurrence rate: up to 10% within 5 years […] CMI most commonly occurs in adults 60 years of age.

• #18 Ischemic colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ischaemic-colitis?ref=binfind.com%2Fweb

  Ischemic bowel is typically a disease of the elderly (age 60 years) where atherosclerotic disease or low flow states are usually the cause. It is rare in younger individuals, where it is more likely to be related to vasculitis or hypercoagulable states. […] Prognosis is variable: resolution without ongoing complications ~50%, persistent colitis ~20%, ischemic stricture ~10%, gangrene or perforation ~20%. […] Occlusive mesenteric infarction (embolus or thrombosis) has a high mortality rate (~90%) compared to non-occlusive ischemia (~10%).

• #19 Systematic review: the epidemiology of ischaemic colitis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/15043513/

  Ischaemic colitis has been associated with co-morbid conditions, medications, vascular surgery and advanced age in case reports and case series. […] Few data exist on the baseline incidence in the general population or on the increased risk imposed by these risk factors. […] To systematically review the literature regarding the incidence, prevalence and risk factors for ischaemic colitis. […] Four studies were identified that reported the general population incidence and four that reported the disease-specific population incidence. The incidence of ischaemic colitis in general populations ranged from 4.5 to 44 cases per 100 000 person-years. The risk was increased two- to four-fold by either prevalent irritable bowel syndrome or chronic obstructive pulmonary disease. The risk was also increased in females and in subjects of 65 years and older. […] Ischaemic colitis is uncommon in the general population. The effect sizes of the most commonly reported risk factors have not been adequately quantified in population-based studies.

• #20 Ischemic colitis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Ischemic_colitis_epidemiology_and_demographics

  Ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia. Ischemic colitis is responsible for about 50 out of 100,000 hospital admissions, and is seen on about 100 in 100,000 endoscopies. […] The exact incidence of ischemic colitis is difficult to estimate, as many patients with mild ischemia may not seek medical attention. Ischemic colitis is responsible for about 50 out of 100,000 hospital admissions, and is seen on about 100 in 100,000 endoscopies. […] Ischemic colitis is a disease of the elderly, with greater than 90% of cases occurring in people over the age of 60. […] Females are more likely to suffer from ischemic colitis than are males.

• #21

  https://journals.lww.com/ajg/fulltext/2004/10001/background_epidemiology_of_ischemic_colitis__335.332.aspx

  A recent study reported a 4-fold increased rate of ischemic colitis (IC) among patients with irritable bowel syndrome (IBS) compared to a control group without IBS. The rate of IC in that control group was 40 per 100,000 person-years. […] The prevalence of IC identified from the screening colonoscopy was 49.6 per 100,000 persons (2 in 4,033). […] The prevalence of IC identified from the DC was 329.1 per 100,000 persons (853 in 259,225); 72.0% of which were female. […] The cross-sectional analysis revealed an annual population prevalence of IC of 42.1, 39.4, 41.6, 49.7 per 100,000 persons from 1999 to 2002, respectively. […] In this population based study, we found a consistent annual prevalence of IC to be about 40 per 100,000 persons. Among those that had a screening colonoscopy, we found a prevalence of IC equal to 49.6 per 100,000 persons, indicating a relatively high occurrence of IC even among patients not seeking care for GI-related symptoms.

• #22 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Ischemic colitis includes a wide clinical spectrum ranging from mild to severe forms. This study aimed to determine the factors that are related to the occurrence of severe ischemic colitis. […] The occurrence of ischemic colitis increases with age in general; having said that, it can occur at any age. It has been known that this disease is accompanied by various diseases such as hypertension, coronary heart disease, diabetes, chronic obstructive pulmonary disease, and chronic kidney disease. […] In previous studies, the following poor prognostic factors have been found: old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis.

• #23 SciELO Brasil – Ischemic colitis: risk factors, diagnosis and prognosis in patients undergoing surgery Ischemic colitis: risk factors, diagnosis and prognosis in patients undergoing surgery

  https://www.scielo.br/j/jcol/a/g6mNQ54GyDGK7w6mTnYdfsQ/

  Ischemic colitis is the most common cause of ischemic change of the gastrointestinal tract. This disease has a wide distribution in different age groups, with an incidence mainly in older people. With the progressive aging of the population, it is estimated a further increase of cases. Mortality rates exceeding 50% are found. These high mortality rates are influenced by several factors, such as the existence of a large number of comorbidities, the late diagnosis of this condition, and inappropriate treatment. Its incidence is unknown. […] There are several risk factors associated with ischemic colitis: age over 65 years, female gender, chronic obstructive pulmonary disease, hypertension, type II diabetes mellitus, dyslipidemia, cardiac arrhythmias (including atrial fibrillation), coronary disease, heart failure, chronic obstipation, renal failure, peripheral arterial occlusive disease, among others. Some drugs are associated with ischemic colitis; aspirin and digitalis are independent risk factors for the development of this disease.

• #24 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Ischemic colitis includes a wide clinical spectrum ranging from mild to severe forms. This study aimed to determine the factors that are related to the occurrence of severe ischemic colitis. […] The occurrence of ischemic colitis increases with age in general; having said that, it can occur at any age. It has been known that this disease is accompanied by various diseases such as hypertension, coronary heart disease, diabetes, chronic obstructive pulmonary disease, and chronic kidney disease. […] In previous studies, the following poor prognostic factors have been found: old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis.

• #25 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Ischemic colitis includes a wide clinical spectrum ranging from mild to severe forms. This study aimed to determine the factors that are related to the occurrence of severe ischemic colitis. […] The occurrence of ischemic colitis increases with age in general; having said that, it can occur at any age. It has been known that this disease is accompanied by various diseases such as hypertension, coronary heart disease, diabetes, chronic obstructive pulmonary disease, and chronic kidney disease. […] In previous studies, the following poor prognostic factors have been found: old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis.

• #26 SciELO Brasil – Ischemic colitis: risk factors, diagnosis and prognosis in patients undergoing surgery Ischemic colitis: risk factors, diagnosis and prognosis in patients undergoing surgery

  https://www.scielo.br/j/jcol/a/g6mNQ54GyDGK7w6mTnYdfsQ/

  Ischemic colitis is the most common cause of ischemic change of the gastrointestinal tract. This disease has a wide distribution in different age groups, with an incidence mainly in older people. With the progressive aging of the population, it is estimated a further increase of cases. Mortality rates exceeding 50% are found. These high mortality rates are influenced by several factors, such as the existence of a large number of comorbidities, the late diagnosis of this condition, and inappropriate treatment. Its incidence is unknown. […] There are several risk factors associated with ischemic colitis: age over 65 years, female gender, chronic obstructive pulmonary disease, hypertension, type II diabetes mellitus, dyslipidemia, cardiac arrhythmias (including atrial fibrillation), coronary disease, heart failure, chronic obstipation, renal failure, peripheral arterial occlusive disease, among others. Some drugs are associated with ischemic colitis; aspirin and digitalis are independent risk factors for the development of this disease.

• #27 Systematic review: the epidemiology of ischaemic colitis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/15043513/

  Ischaemic colitis has been associated with co-morbid conditions, medications, vascular surgery and advanced age in case reports and case series. […] Few data exist on the baseline incidence in the general population or on the increased risk imposed by these risk factors. […] To systematically review the literature regarding the incidence, prevalence and risk factors for ischaemic colitis. […] Four studies were identified that reported the general population incidence and four that reported the disease-specific population incidence. The incidence of ischaemic colitis in general populations ranged from 4.5 to 44 cases per 100 000 person-years. The risk was increased two- to four-fold by either prevalent irritable bowel syndrome or chronic obstructive pulmonary disease. The risk was also increased in females and in subjects of 65 years and older. […] Ischaemic colitis is uncommon in the general population. The effect sizes of the most commonly reported risk factors have not been adequately quantified in population-based studies.

• #28 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Ischemic colitis includes a wide clinical spectrum ranging from mild to severe forms. This study aimed to determine the factors that are related to the occurrence of severe ischemic colitis. […] The occurrence of ischemic colitis increases with age in general; having said that, it can occur at any age. It has been known that this disease is accompanied by various diseases such as hypertension, coronary heart disease, diabetes, chronic obstructive pulmonary disease, and chronic kidney disease. […] In previous studies, the following poor prognostic factors have been found: old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis.

• #29 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Ischemic colitis includes a wide clinical spectrum ranging from mild to severe forms. This study aimed to determine the factors that are related to the occurrence of severe ischemic colitis. […] The occurrence of ischemic colitis increases with age in general; having said that, it can occur at any age. It has been known that this disease is accompanied by various diseases such as hypertension, coronary heart disease, diabetes, chronic obstructive pulmonary disease, and chronic kidney disease. […] In previous studies, the following poor prognostic factors have been found: old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis.

• #30 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Currently known prognostic factors of severe ischemic colitis are old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis. […] In this study, the ratio of the involvement of the right colon in the severe group was statistically significant; however, multivariate analysis did not show it to be an independent factor that can influence the severity. […] In conclusion, factors that can predict poor prognosis in ischemic colitis were comorbidity of chronic kidney disease and high ECOG performance status score. Therefore, it is necessary for patients with suspicious ischemic colitis to receive active treatment (e.g., surgery) at an early stage and to be observed carefully if they are treated with chronic kidney disease and if their performance status is poor overall.

• #31

  http://annalsgastro.gr/index.php/annalsgastro/article/view/5619

  Ischemic colitis is a relatively common gastrointestinal disease caused by hypoperfusion of the colon. […] This systematic review and meta-analysis were performed to comprehensively explore whether patients with HF are at a higher risk of ischemic colitis compared with individuals without HF by combining the results of all available observational studies. […] The pooled analysis found that patients with HF had a significantly higher risk of ischemic colitis with the pooled odds ratio of 3.42 (95% confidence interval 1.49-7.82; I2 96%). […] A significantly increased risk of ischemic colitis among patients with HF was demonstrated in this systematic review and meta-analysis.

• #32 The Associations Between Gout and Ischemic Colitis Among Hospitalized Patients: A Retrospective Nationwide Analysis – ACR Meeting Abstracts

  https://acrabstracts.org/abstract/the-associations-between-gout-and-ischemic-colitis-among-hospitalized-patients-a-retrospective-nationwide-analysis/

  The relationship between gout and ischemic colitis, the most common presentation of mesenteric ischemia, is not well-studied. […] Our study identified gout as a potential risk factor for developing ischemic colitis, which is consistent with previous literature identifying elevated risk of other ischemic events in patients with gout. […] However, our study found that presence of gout among hospitalized patients with ischemic colitis was associated with lower odds of sepsis, shock, ICU admission, and death. Gout may be a marker of better outcomes in patients with ischemic colitis, bringing about the question of antioxidative effects of uric acid playing a role. Further studies are needed to explore the underlying mechanisms of our findings.

• #33 Systematic review: the epidemiology of ischaemic colitis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/15043513/

  Ischaemic colitis has been associated with co-morbid conditions, medications, vascular surgery and advanced age in case reports and case series. […] Few data exist on the baseline incidence in the general population or on the increased risk imposed by these risk factors. […] To systematically review the literature regarding the incidence, prevalence and risk factors for ischaemic colitis. […] Four studies were identified that reported the general population incidence and four that reported the disease-specific population incidence. The incidence of ischaemic colitis in general populations ranged from 4.5 to 44 cases per 100 000 person-years. The risk was increased two- to four-fold by either prevalent irritable bowel syndrome or chronic obstructive pulmonary disease. The risk was also increased in females and in subjects of 65 years and older. […] Ischaemic colitis is uncommon in the general population. The effect sizes of the most commonly reported risk factors have not been adequately quantified in population-based studies.

• #34 A Population-Based Study of Incidence, Risk Factors, Clinical Spectrum, and Outcomes of Ischemic Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4326614/

  Little is known about progression of ischemic colitis (IC) among unselected patients. We aimed to estimate the incidence, risk factors, and natural history of IC in a population-based cohort in Olmsted County, Minnesota. The age- and sex-adjusted incidence rates of IC nearly quadrupled, from 6.1 cases/100,000 person-years in 1976-1980 to 22.9/100,000 in 2005-2009. The incidence of IC increased over the past 3 decades in a population-based cohort in Minnesota. There is a paucity of epidemiological data derived from review of actual patient medical records, especially on the incidence and risk factors of IC in the general population. The overall annual incidence of IC between 1976 and 2009 was 16 cases per 100,000 person-years. The age-and sex- adjusted incidence of IC nearly quadrupled over the course of 34 years, from 6.1 cases per 100,000 person-years in 1976-1980 to 22.9 per 100,000 person-years in 2005-2009. The rapid rise in incidence of IC over 34 years may have been due to a number of factors, including increasing life expectancy for patients with underlying predisposing chronic diseases, especially atherosclerotic diseases. In our population, IBS was not a risk factor for IC. The five-year survival among IC cases was 58% as compared to 90% in the Olmsted County controls. Age older than 50 years, right-sided colonic involvement, small bowel involvement, COPD and male gender were all independent predictors of mortality.

• #35 Prevalence and predictive value of sarcopenia in hospitalized patients with ischemic colitis | Scientific Reports

  https://www.nature.com/articles/s41598-024-65243-6

  Ischemic colitis (IC) occurs owing to blood flow that is insufficient to maintain the metabolic function of colonocytes and it accounts for 75% of intestinal ischemia. […] Additionally, a population-based cohort study in the United States found that the annual incidence of IC was 16.3 per 100,000 person-years, and it has increased over the past three decades. […] The incidence of IC tends to increase with age, and is associated with various medical conditions, surgical history, and drug usage. […] Identifying poor prognostic factors for IC and determining early intervention would help to improve the outcomes of IC treatment. […] The prevalence of sarcopenia in hospitalized patients with IC differed according to whether it was defined as SMA/BMI (49.3%) or SMA/height2 (34.7%). […] The prognosis of patients with sarcopenia was worse in terms of IC. […] Moreover, sarcopenia was identified as an independent predictor of mortality or surgical intervention. […] These findings suggest the need for meticulous monitoring, prompt medical treatment, and timely surgical consultation, particularly for patients with IC and sarcopenia.

• #36 Ischemic colitis involving the right-side colon: clinical case report and diagnostic considerations – Huang – Journal of Xiangya Medicine

  https://jxym.amegroups.org/article/view/8132/html

  Ischemic colitis is the most common form of gastrointestinal ischemia. […] The incidence of ischemic colitis is about 15.6/100,000 person-year. […] Most colonic ischemia occurs in the left-side, they usually have a good prognosis. But when lesion involves the right-side colon, patients may have a higher surgery rate and in-hospital mortality. […] ACG Clinical Guideline considers CT the main technique for the non-invasive diagnosis of ischemic colitis. […] When colonoscopy is difficult to perform, risk factor analysis can be helpful in clinical diagnosis. […] Patients with ischemic colitis usually have identifiable risk factors. […] In this case, we inferred that the rash may also be a risk factor. […] Diabetes is also a potential risk factor. […] Early diagnosis of ischemic colitis has always been a difficult problem, most of the challenges come from its unspecific clinical manifestations.

• #37 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] Older patients with risk factors for atherosclerosis are at especially high risk for developing colon ischemia. […] Overall mortality: 4-12% […] Recurrence rate: up to 10% within 5 years […] CMI most commonly occurs in adults 60 years of age.

• #38 Clinical Characteristics of Ischemic Colitis According to Location

  https://coloproctol.org/journal/view.php?number=1453

  The aim of this study was to analyze various clinical characteristics of ischemic colitis according to its location. […] The incidence of ischemic colitis may be underestimated due to the broad spectrum of diverse clinical courses. […] Ischemic colitis may occur in any part of the colon. […] According to Sotiriadis et al., despite being only 10% of all ischemic colitis cases, patients with ischemic colitis confined to the right colon mainly showed severe clinical presentation, and more than 50% of them needed surgery. […] Our study, with statistical significance, indicates a higher prevalence of right-sided ischemic colitis in patients with renal failure, especially those on hemodialysis. […] A statistical analysis comparing ischemic colitis confined to the right colon to left-sided ischemic colitis showed that right-sided ischemic colitis required more surgical treatment and showed a higher mortality rate than left-sided ischemic colitis.

• #39 Clinical Characteristics of Ischemic Colitis According to Location

  https://coloproctol.org/journal/view.php?number=1453

  The aim of this study was to analyze various clinical characteristics of ischemic colitis according to its location. […] The incidence of ischemic colitis may be underestimated due to the broad spectrum of diverse clinical courses. […] Ischemic colitis may occur in any part of the colon. […] According to Sotiriadis et al., despite being only 10% of all ischemic colitis cases, patients with ischemic colitis confined to the right colon mainly showed severe clinical presentation, and more than 50% of them needed surgery. […] Our study, with statistical significance, indicates a higher prevalence of right-sided ischemic colitis in patients with renal failure, especially those on hemodialysis. […] A statistical analysis comparing ischemic colitis confined to the right colon to left-sided ischemic colitis showed that right-sided ischemic colitis required more surgical treatment and showed a higher mortality rate than left-sided ischemic colitis.

• #40 A Rare Case of Ischemic Colitis due to Ergotamine – MedCrave online

  https://medcraveonline.com/GHOA/a-rare-case-of-ischemic-colitis-due-to-ergotamine.html

  Ischemic colitis is caused by the temporary deprivation of blood flow to the large bowel, due to a local or systemic alteration of the blood supply. Its incidence varies between 4,5 to 44 cases every 100,000 people per year. People affected by this entity are mainly female over 60 years old. However, there are cases reported in young people with no risk factors. The risk factors identified are high blood pressure, diabetes mellitus, dyslipidemia, coronary disease and drugs, such as NSAIDs, ergotamine, cocaine, antibiotics, cytotoxic drugs and vasoactive agents. […] Ischemic colitis is the most frequent form of intestinal ischemia and occurs when the large bowel is deprived of blood flow. A high level of suspicion is required for its diagnosis. […] Diagnosis of ischemic colitis due to ergotamine begins with a high suspicion rate. It can then be established by comprehensive anamnesis, especially in patients with no vascular disease. Every physician working at an emergency department and surgeons should be aware of this infrequent condition. […] Drugs induced ischemic colitis is a rare entity, probably under diagnosed, and it should be considered ergotamine in ischemic colitis differential diagnosis.

• #41 A Case of Ischemic Colitis Related with Usual Dosage of Ibuprofen in a Young Man

  https://www.kosinmedj.org/journal/view.php?doi=10.7180/kmj.2014.29.2.147

  Ischemic colitis is a medical condition in which inflammation and injury of the large intestine result from inadequate blood supply. Although uncommon in the general population, ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia. […] In recent years, many of NSAID use in young age can cause ischemic lesions, but it is not common. […] It suggests the importance of precise history taking, including medications usage such as NSAIDs and other risk factors. […] Systematic review: the epidemiology of ischaemic colitis. […] Ischemic colitis: a clinical review.

• #42 Severe ischemic colitis following olanzapine use: a Case Report

  http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000900018

  Ischemic colitis represents the most common form of intestinal ischemia with an incidence estimated between 4.5 and 44 cases per 100,000 person-years (1). […] Age represents an important risk factor as up to 90% of ischemic colitis occurs in patients over 60 years of age (2). […] Many drugs have been associated with ischemic colitis including antibiotics, anti-inflammatory drugs, vasopressors, cytotoxic agents, and neuroleptics (4). […] A study from the French Pharmacovigilance database also linked olanzapine to at least 4 potential cases of ischemic colitis (10). […] The spectrum of altered intestinal motility induced by neuroleptics includes constipation, gastric outlet obstruction, paralytic ileus, intestinal obstruction, ischemia, necrosis and perforation (11,12). […] Although severe, ischemic colitis has been infrequently linked to neuroleptics, occurring in only 0.3% of patients exposed to clozapine (5).

• #43 Severe ischemic colitis following olanzapine use: a Case Report

  http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000900018

  Ischemic colitis represents the most common form of intestinal ischemia with an incidence estimated between 4.5 and 44 cases per 100,000 person-years (1). […] Age represents an important risk factor as up to 90% of ischemic colitis occurs in patients over 60 years of age (2). […] Many drugs have been associated with ischemic colitis including antibiotics, anti-inflammatory drugs, vasopressors, cytotoxic agents, and neuroleptics (4). […] A study from the French Pharmacovigilance database also linked olanzapine to at least 4 potential cases of ischemic colitis (10). […] The spectrum of altered intestinal motility induced by neuroleptics includes constipation, gastric outlet obstruction, paralytic ileus, intestinal obstruction, ischemia, necrosis and perforation (11,12). […] Although severe, ischemic colitis has been infrequently linked to neuroleptics, occurring in only 0.3% of patients exposed to clozapine (5).

• #44 A Rare Case of Ischemic Colitis due to Ergotamine – MedCrave online

  https://medcraveonline.com/GHOA/a-rare-case-of-ischemic-colitis-due-to-ergotamine.html

  Ischemic colitis is caused by the temporary deprivation of blood flow to the large bowel, due to a local or systemic alteration of the blood supply. Its incidence varies between 4,5 to 44 cases every 100,000 people per year. People affected by this entity are mainly female over 60 years old. However, there are cases reported in young people with no risk factors. The risk factors identified are high blood pressure, diabetes mellitus, dyslipidemia, coronary disease and drugs, such as NSAIDs, ergotamine, cocaine, antibiotics, cytotoxic drugs and vasoactive agents. […] Ischemic colitis is the most frequent form of intestinal ischemia and occurs when the large bowel is deprived of blood flow. A high level of suspicion is required for its diagnosis. […] Diagnosis of ischemic colitis due to ergotamine begins with a high suspicion rate. It can then be established by comprehensive anamnesis, especially in patients with no vascular disease. Every physician working at an emergency department and surgeons should be aware of this infrequent condition. […] Drugs induced ischemic colitis is a rare entity, probably under diagnosed, and it should be considered ergotamine in ischemic colitis differential diagnosis.

• #45 Severe ischemic colitis following olanzapine use: a Case Report

  http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082016000900018

  Ischemic colitis represents the most common form of intestinal ischemia with an incidence estimated between 4.5 and 44 cases per 100,000 person-years (1). […] Age represents an important risk factor as up to 90% of ischemic colitis occurs in patients over 60 years of age (2). […] Many drugs have been associated with ischemic colitis including antibiotics, anti-inflammatory drugs, vasopressors, cytotoxic agents, and neuroleptics (4). […] A study from the French Pharmacovigilance database also linked olanzapine to at least 4 potential cases of ischemic colitis (10). […] The spectrum of altered intestinal motility induced by neuroleptics includes constipation, gastric outlet obstruction, paralytic ileus, intestinal obstruction, ischemia, necrosis and perforation (11,12). […] Although severe, ischemic colitis has been infrequently linked to neuroleptics, occurring in only 0.3% of patients exposed to clozapine (5).

• #46 A Rare Case of Ischemic Colitis due to Ergotamine – MedCrave online

  https://medcraveonline.com/GHOA/a-rare-case-of-ischemic-colitis-due-to-ergotamine.html

  Ischemic colitis is caused by the temporary deprivation of blood flow to the large bowel, due to a local or systemic alteration of the blood supply. Its incidence varies between 4,5 to 44 cases every 100,000 people per year. People affected by this entity are mainly female over 60 years old. However, there are cases reported in young people with no risk factors. The risk factors identified are high blood pressure, diabetes mellitus, dyslipidemia, coronary disease and drugs, such as NSAIDs, ergotamine, cocaine, antibiotics, cytotoxic drugs and vasoactive agents. […] Ischemic colitis is the most frequent form of intestinal ischemia and occurs when the large bowel is deprived of blood flow. A high level of suspicion is required for its diagnosis. […] Diagnosis of ischemic colitis due to ergotamine begins with a high suspicion rate. It can then be established by comprehensive anamnesis, especially in patients with no vascular disease. Every physician working at an emergency department and surgeons should be aware of this infrequent condition. […] Drugs induced ischemic colitis is a rare entity, probably under diagnosed, and it should be considered ergotamine in ischemic colitis differential diagnosis.

• #47 A Rare Case of Ischemic Colitis due to Ergotamine – MedCrave online

  https://medcraveonline.com/GHOA/a-rare-case-of-ischemic-colitis-due-to-ergotamine.html

  Ischemic colitis is caused by the temporary deprivation of blood flow to the large bowel, due to a local or systemic alteration of the blood supply. Its incidence varies between 4,5 to 44 cases every 100,000 people per year. People affected by this entity are mainly female over 60 years old. However, there are cases reported in young people with no risk factors. The risk factors identified are high blood pressure, diabetes mellitus, dyslipidemia, coronary disease and drugs, such as NSAIDs, ergotamine, cocaine, antibiotics, cytotoxic drugs and vasoactive agents. […] Ischemic colitis is the most frequent form of intestinal ischemia and occurs when the large bowel is deprived of blood flow. A high level of suspicion is required for its diagnosis. […] Diagnosis of ischemic colitis due to ergotamine begins with a high suspicion rate. It can then be established by comprehensive anamnesis, especially in patients with no vascular disease. Every physician working at an emergency department and surgeons should be aware of this infrequent condition. […] Drugs induced ischemic colitis is a rare entity, probably under diagnosed, and it should be considered ergotamine in ischemic colitis differential diagnosis.

• #48 SciELO Brasil – Ischemic colitis: risk factors, diagnosis and prognosis in patients undergoing surgery Ischemic colitis: risk factors, diagnosis and prognosis in patients undergoing surgery

  https://www.scielo.br/j/jcol/a/g6mNQ54GyDGK7w6mTnYdfsQ/

  Ischemic colitis is the most common cause of ischemic change of the gastrointestinal tract. This disease has a wide distribution in different age groups, with an incidence mainly in older people. With the progressive aging of the population, it is estimated a further increase of cases. Mortality rates exceeding 50% are found. These high mortality rates are influenced by several factors, such as the existence of a large number of comorbidities, the late diagnosis of this condition, and inappropriate treatment. Its incidence is unknown. […] There are several risk factors associated with ischemic colitis: age over 65 years, female gender, chronic obstructive pulmonary disease, hypertension, type II diabetes mellitus, dyslipidemia, cardiac arrhythmias (including atrial fibrillation), coronary disease, heart failure, chronic obstipation, renal failure, peripheral arterial occlusive disease, among others. Some drugs are associated with ischemic colitis; aspirin and digitalis are independent risk factors for the development of this disease.

• #49

  https://link.springer.com/article/10.1007/s00384-020-03739-z

  Ischemic colitis (IC) is the most prevalent ischemic injury of the gastrointestinal tract. […] To comprehensively detail the current state of diagnostic methods and available drug therapies for detecting and treating IC, this review aims to provide a concise and practical summary of the corresponding literature. […] Colonoscopy combined with histopathological biopsy is the standard of diagnosis for the IC. […] Accurate diagnoses and effective treatments have helped reduce the mortality rate and improve prognoses for patients afflicted with IC, and corresponding drug therapies have been constantly updated as new research has emerged.

• #50 Ischemic Colitis Presented as Pseudomembranous Colitis: An Untypical Case from Vietnam

  https://www.kjg.or.kr/journal/view.html?volume=80&number=2&spage=93

  Ischemic colitis (IC) is one of the most frequent forms of ischemic bowel disease, with various presentations depending on the injury’s onset, duration, and extent of involvement in colon segments. A diagnosis of IC is based on multi-aspects (history, physical examination, risk factors, imaging modalities, endoscopic and pathologic evidence). IC had diverse manifestations, ranging from acute colitis (including PMC) to chronic colitis or complications (stricture, gangrenous bowel, and fulminant pancolitis. Although IC is one of the most prevalent types of ischemic bowel disease, it may be underrated in tropical areas where infectious colitis predominates. This is the first IC case reported in the Vietnamese population to the authors knowledge. Colonoscopy has been regarded as the gold standard diagnostic approach by directly observing the colonic mucosa and obtaining biopsy specimens, which can overcome the difficulty of recognizing IC. Most cases should be treated conservatively with close monitoring if there is no evidence of gangrene, perforation, bleeding, or peritonitis. On the other hand, early surgical consultation is indicated for patients with systemic disease and failure of conventional therapy.

• #51 Ischemic colitis involving the right-side colon: clinical case report and diagnostic considerations – Huang – Journal of Xiangya Medicine

  https://jxym.amegroups.org/article/view/8132/html

  Ischemic colitis is the most common form of gastrointestinal ischemia. […] The incidence of ischemic colitis is about 15.6/100,000 person-year. […] Most colonic ischemia occurs in the left-side, they usually have a good prognosis. But when lesion involves the right-side colon, patients may have a higher surgery rate and in-hospital mortality. […] ACG Clinical Guideline considers CT the main technique for the non-invasive diagnosis of ischemic colitis. […] When colonoscopy is difficult to perform, risk factor analysis can be helpful in clinical diagnosis. […] Patients with ischemic colitis usually have identifiable risk factors. […] In this case, we inferred that the rash may also be a risk factor. […] Diabetes is also a potential risk factor. […] Early diagnosis of ischemic colitis has always been a difficult problem, most of the challenges come from its unspecific clinical manifestations.

• #52 Ischemic Colitis Presented as Pseudomembranous Colitis: An Untypical Case from Vietnam

  https://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2022.023

  Ischemic colitis (IC) is one of the most frequent forms of ischemic bowel disease, with various presentations depending on the injury’s onset, duration, and extent of involvement in colon segments. A diagnosis of IC is based on multi-aspects (history, physical examination, risk factors, imaging modalities, endoscopic and pathologic evidence). IC had diverse manifestations, ranging from acute colitis (including PMC) to chronic colitis or complications (stricture, gangrenous bowel, and fulminant pancolitis. Although IC is one of the most prevalent types of ischemic bowel disease, it may be underrated in tropical areas where infectious colitis predominates. This is the first IC case reported in the Vietnamese population to the authors knowledge. Colonoscopy has been regarded as the gold standard diagnostic approach by directly observing the colonic mucosa and obtaining biopsy specimens, which can overcome the difficulty of recognizing IC. The endoscopic examination revealed nonspecific pseudomembranous colitis with ulcers from the rectum to the splenic flexure. Regarding the imaging modality, a CT scan can be helpful in a diagnosis of IC. Most cases should be treated conservatively with close monitoring if there is no evidence of gangrene, perforation, bleeding, or peritonitis. In summary, in tropical areas, the coexistence of infectious colitis can aggravate a preexisting ischemic condition. Raising physician awareness and vigilance about this disease is critical for establishing an early diagnosis and prompt management, particularly in elderly individuals presenting with abdominal pain, chronic diarrhea, rectal bleeding, and the presence of comorbid disease.

• #53 Ischemic colitis involving the right-side colon: clinical case report and diagnostic considerations – Huang – Journal of Xiangya Medicine

  https://jxym.amegroups.org/article/view/8132/html

  Ischemic colitis is the most common form of gastrointestinal ischemia. […] The incidence of ischemic colitis is about 15.6/100,000 person-year. […] Most colonic ischemia occurs in the left-side, they usually have a good prognosis. But when lesion involves the right-side colon, patients may have a higher surgery rate and in-hospital mortality. […] ACG Clinical Guideline considers CT the main technique for the non-invasive diagnosis of ischemic colitis. […] When colonoscopy is difficult to perform, risk factor analysis can be helpful in clinical diagnosis. […] Patients with ischemic colitis usually have identifiable risk factors. […] In this case, we inferred that the rash may also be a risk factor. […] Diabetes is also a potential risk factor. […] Early diagnosis of ischemic colitis has always been a difficult problem, most of the challenges come from its unspecific clinical manifestations.

• #54 Ischemic colitis involving the right-side colon: clinical case report and diagnostic considerations – Huang – Journal of Xiangya Medicine

  https://jxym.amegroups.org/article/view/8132/html

  Ischemic colitis is the most common form of gastrointestinal ischemia. […] The incidence of ischemic colitis is about 15.6/100,000 person-year. […] Most colonic ischemia occurs in the left-side, they usually have a good prognosis. But when lesion involves the right-side colon, patients may have a higher surgery rate and in-hospital mortality. […] ACG Clinical Guideline considers CT the main technique for the non-invasive diagnosis of ischemic colitis. […] When colonoscopy is difficult to perform, risk factor analysis can be helpful in clinical diagnosis. […] Patients with ischemic colitis usually have identifiable risk factors. […] In this case, we inferred that the rash may also be a risk factor. […] Diabetes is also a potential risk factor. […] Early diagnosis of ischemic colitis has always been a difficult problem, most of the challenges come from its unspecific clinical manifestations.

• #55 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  Ischemic colitis (IC) is the underlying etiology in 16-24% of acute lower gastrointestinal bleeds (LGIBs). As individuals with IC often present with non-specific symptoms, approximately 80% of cases are missed during the initial patient encounter. In the ED, IC is correctly diagnosed in only 9% of the cases (when compared to final inpatient diagnoses). With a 10-15% mortality rate and increasing incidence in the U.S., IC is a diagnosis that should not be missed. […] Patients with IC are most often at least 50 years old; female; and have a history of hypertension, vascular disease, chronic kidney disease, and/or diabetes. IC may also be seen in young persons with collagen vascular diseases, polyangiitis granulomatosis, and amyloidosis. […] While there is no current American College of Emergency Physicians guideline pertaining to ischemic colitis, an excellent guideline based upon nearly 200 resources has been offered by the American College of Gastroenterology (ACG). In this publication, the authors recommend diagnosis based upon the presence of symptoms consistent with IC (e.g. sudden cramping, mild abdominal pain, urgent desire to defecate, and passage of bright red or maroon blood or bloody diarrhea within 24 hours of the onset of symptoms). The certainty of this diagnosis is strengthened in the setting of the risk factors discussed above.

• #56 Ischemic colitis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Ischemic_colitis_epidemiology_and_demographics

  Ischemic colitis occurs with greater frequency in the elderly, and is the most common form of bowel ischemia. Ischemic colitis is responsible for about 50 out of 100,000 hospital admissions, and is seen on about 100 in 100,000 endoscopies. […] The exact incidence of ischemic colitis is difficult to estimate, as many patients with mild ischemia may not seek medical attention. Ischemic colitis is responsible for about 50 out of 100,000 hospital admissions, and is seen on about 100 in 100,000 endoscopies. […] Ischemic colitis is a disease of the elderly, with greater than 90% of cases occurring in people over the age of 60. […] Females are more likely to suffer from ischemic colitis than are males.

• #57 Ischemic colitis – Wikipedia

  https://en.wikipedia.org/wiki/Ischemic_colitis

  The exact incidence of ischemic colitis is difficult to estimate, as many patients with mild ischemia may not seek medical attention. Ischemic colitis is responsible for about 1 in 2000 hospital admissions and is seen on about 1 in 100 endoscopies. Men and women are affected equally; ischemic colitis is a disease of the elderly, with more than 90% of cases occurring in people over the age of 60.

• #58 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  Ischemic colitis (IC) is the underlying etiology in 16-24% of acute lower gastrointestinal bleeds (LGIBs). As individuals with IC often present with non-specific symptoms, approximately 80% of cases are missed during the initial patient encounter. In the ED, IC is correctly diagnosed in only 9% of the cases (when compared to final inpatient diagnoses). With a 10-15% mortality rate and increasing incidence in the U.S., IC is a diagnosis that should not be missed. […] Patients with IC are most often at least 50 years old; female; and have a history of hypertension, vascular disease, chronic kidney disease, and/or diabetes. IC may also be seen in young persons with collagen vascular diseases, polyangiitis granulomatosis, and amyloidosis. […] While there is no current American College of Emergency Physicians guideline pertaining to ischemic colitis, an excellent guideline based upon nearly 200 resources has been offered by the American College of Gastroenterology (ACG). In this publication, the authors recommend diagnosis based upon the presence of symptoms consistent with IC (e.g. sudden cramping, mild abdominal pain, urgent desire to defecate, and passage of bright red or maroon blood or bloody diarrhea within 24 hours of the onset of symptoms). The certainty of this diagnosis is strengthened in the setting of the risk factors discussed above.

• #59 Ischemic Colitis Presented as Pseudomembranous Colitis: An Untypical Case from Vietnam

  https://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2022.023

  Ischemic colitis (IC) is one of the most frequent forms of ischemic bowel disease, with various presentations depending on the injury’s onset, duration, and extent of involvement in colon segments. A diagnosis of IC is based on multi-aspects (history, physical examination, risk factors, imaging modalities, endoscopic and pathologic evidence). IC had diverse manifestations, ranging from acute colitis (including PMC) to chronic colitis or complications (stricture, gangrenous bowel, and fulminant pancolitis. Although IC is one of the most prevalent types of ischemic bowel disease, it may be underrated in tropical areas where infectious colitis predominates. This is the first IC case reported in the Vietnamese population to the authors knowledge. Colonoscopy has been regarded as the gold standard diagnostic approach by directly observing the colonic mucosa and obtaining biopsy specimens, which can overcome the difficulty of recognizing IC. The endoscopic examination revealed nonspecific pseudomembranous colitis with ulcers from the rectum to the splenic flexure. Regarding the imaging modality, a CT scan can be helpful in a diagnosis of IC. Most cases should be treated conservatively with close monitoring if there is no evidence of gangrene, perforation, bleeding, or peritonitis. In summary, in tropical areas, the coexistence of infectious colitis can aggravate a preexisting ischemic condition. Raising physician awareness and vigilance about this disease is critical for establishing an early diagnosis and prompt management, particularly in elderly individuals presenting with abdominal pain, chronic diarrhea, rectal bleeding, and the presence of comorbid disease.

• #60 A Population-Based Study of Incidence, Risk Factors, Clinical Spectrum, and Outcomes of Ischemic Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4326614/

  Little is known about progression of ischemic colitis (IC) among unselected patients. We aimed to estimate the incidence, risk factors, and natural history of IC in a population-based cohort in Olmsted County, Minnesota. The age- and sex-adjusted incidence rates of IC nearly quadrupled, from 6.1 cases/100,000 person-years in 1976-1980 to 22.9/100,000 in 2005-2009. The incidence of IC increased over the past 3 decades in a population-based cohort in Minnesota. There is a paucity of epidemiological data derived from review of actual patient medical records, especially on the incidence and risk factors of IC in the general population. The overall annual incidence of IC between 1976 and 2009 was 16 cases per 100,000 person-years. The age-and sex- adjusted incidence of IC nearly quadrupled over the course of 34 years, from 6.1 cases per 100,000 person-years in 1976-1980 to 22.9 per 100,000 person-years in 2005-2009. The rapid rise in incidence of IC over 34 years may have been due to a number of factors, including increasing life expectancy for patients with underlying predisposing chronic diseases, especially atherosclerotic diseases. In our population, IBS was not a risk factor for IC. The five-year survival among IC cases was 58% as compared to 90% in the Olmsted County controls. Age older than 50 years, right-sided colonic involvement, small bowel involvement, COPD and male gender were all independent predictors of mortality.

• #61 Ischemic Colitis Presented as Pseudomembranous Colitis: An Untypical Case from Vietnam

  https://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2022.023

  Ischemic colitis (IC) is one of the most frequent forms of ischemic bowel disease, with various presentations depending on the injury’s onset, duration, and extent of involvement in colon segments. A diagnosis of IC is based on multi-aspects (history, physical examination, risk factors, imaging modalities, endoscopic and pathologic evidence). IC had diverse manifestations, ranging from acute colitis (including PMC) to chronic colitis or complications (stricture, gangrenous bowel, and fulminant pancolitis. Although IC is one of the most prevalent types of ischemic bowel disease, it may be underrated in tropical areas where infectious colitis predominates. This is the first IC case reported in the Vietnamese population to the authors knowledge. Colonoscopy has been regarded as the gold standard diagnostic approach by directly observing the colonic mucosa and obtaining biopsy specimens, which can overcome the difficulty of recognizing IC. The endoscopic examination revealed nonspecific pseudomembranous colitis with ulcers from the rectum to the splenic flexure. Regarding the imaging modality, a CT scan can be helpful in a diagnosis of IC. Most cases should be treated conservatively with close monitoring if there is no evidence of gangrene, perforation, bleeding, or peritonitis. In summary, in tropical areas, the coexistence of infectious colitis can aggravate a preexisting ischemic condition. Raising physician awareness and vigilance about this disease is critical for establishing an early diagnosis and prompt management, particularly in elderly individuals presenting with abdominal pain, chronic diarrhea, rectal bleeding, and the presence of comorbid disease.

• #62 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #63 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #64 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #65 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #66 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #67 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #68 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #69 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #70 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #71 Factors influencing hospital stay duration for patients with mild ischemic colitis: a retrospective study | European Journal of Medical Research | Full Text

  https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-022-00665-4

  Ischemic colitis is the most prevalent ischemic injury of the gastrointestinal tract. The incidence of IC has continued to increase, and it often occurs in older patients, patients with comorbidities, and women. Additionally, IC is an increasingly common cause of hospitalizations related to lower gastrointestinal bleeding. More than three-fourths of IC cases are the milder, nongangrenous form; however, IC can progress to necrosis with a risk of mortality up to 50%. To date, multiple studies have reported numerous risk factors for IC, including cerebrovascular disease, hypertension, diabetes mellitus, previous history of abdominal surgery, irritable bowel syndrome, and constipation. However, no published studies have addressed the significant predictors of longer hospital stay duration for patients with mild IC. Therefore, the purpose of this study was to identify factors that are associated with longer hospital stays for these patients. Cerebrovascular disease, abdominal surgical history, higher d-dimer levels, and higher positive fecal occult blood test results are independent and significant factors that influence longer hospital stays for patients with mild ischemic colitis. Probiotics helped reduce hospital stay in these patients. The multivariate model showed that patients with a history of cerebrovascular disease or abdominal surgery experienced a significantly longer hospital stay duration than did patients without such histories. Moreover, the hospital stay duration for patients with higher d-dimer levels or positive FOBT results was significantly longer than those of patients with lower d-dimer levels or negative FOBT results. These findings emphasize the importance of early identification of risk factors associated with longer hospital stays and provide a clear target to develop better disease management strategies for patients with mild IC to shorten their hospital stay duration and consequently reduce the cost of healthcare.

• #72 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #73 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #74 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #75 Ischemic Colitis: ED Presentations, Evaluation, and Management – emDocs

  https://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/

  The guideline also recommends extensive laboratory testing for the determination of prognosis and severity: Albumin, amylase, complete blood count, comprehensive electrolyte panel, creatinine kinase, lactate, lactate dehydrogenase (LDH). Low hemoglobin, less than 12 g/dl, or albumin levels less than 2.8 g/l, and the presence of acidosis, as indicated by lactate and LDH, indicate a more severe course. […] Most episodes of IC will resolve spontaneously without specific therapy. However, several factors have been associated with more severe disease and a poorer outcome. Factors indicating severe disease include: male gender (odds ratio 3.94), hypotension (systolic blood pressure <90 mmHg, odds ratio 4.45), tachycardia (heart rate >100 beats/min, odds ratio 4.40), abdominal pain without rectal bleeding (more common in isolated right colon ischemia, odds ratio 3.90), BUN >20 mg/dl, Hgb <12 g/dl (odds ratio 4.50), LDH >350 U/I, serum sodium <136 mEq/l (mmol/l) (odds ratio 4.98), WBC >15 cells/cmm (x10⁹/L) with the higher odds ratio associated with increased requirement for surgery and/or mortality.

• #76 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Currently known prognostic factors of severe ischemic colitis are old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis. […] In this study, the ratio of the involvement of the right colon in the severe group was statistically significant; however, multivariate analysis did not show it to be an independent factor that can influence the severity. […] In conclusion, factors that can predict poor prognosis in ischemic colitis were comorbidity of chronic kidney disease and high ECOG performance status score. Therefore, it is necessary for patients with suspicious ischemic colitis to receive active treatment (e.g., surgery) at an early stage and to be observed carefully if they are treated with chronic kidney disease and if their performance status is poor overall.

• #77 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Currently known prognostic factors of severe ischemic colitis are old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis. […] In this study, the ratio of the involvement of the right colon in the severe group was statistically significant; however, multivariate analysis did not show it to be an independent factor that can influence the severity. […] In conclusion, factors that can predict poor prognosis in ischemic colitis were comorbidity of chronic kidney disease and high ECOG performance status score. Therefore, it is necessary for patients with suspicious ischemic colitis to receive active treatment (e.g., surgery) at an early stage and to be observed carefully if they are treated with chronic kidney disease and if their performance status is poor overall.

• #78 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Currently known prognostic factors of severe ischemic colitis are old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis. […] In this study, the ratio of the involvement of the right colon in the severe group was statistically significant; however, multivariate analysis did not show it to be an independent factor that can influence the severity. […] In conclusion, factors that can predict poor prognosis in ischemic colitis were comorbidity of chronic kidney disease and high ECOG performance status score. Therefore, it is necessary for patients with suspicious ischemic colitis to receive active treatment (e.g., surgery) at an early stage and to be observed carefully if they are treated with chronic kidney disease and if their performance status is poor overall.

• #79 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Currently known prognostic factors of severe ischemic colitis are old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis. […] In this study, the ratio of the involvement of the right colon in the severe group was statistically significant; however, multivariate analysis did not show it to be an independent factor that can influence the severity. […] In conclusion, factors that can predict poor prognosis in ischemic colitis were comorbidity of chronic kidney disease and high ECOG performance status score. Therefore, it is necessary for patients with suspicious ischemic colitis to receive active treatment (e.g., surgery) at an early stage and to be observed carefully if they are treated with chronic kidney disease and if their performance status is poor overall.

• #80 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Currently known prognostic factors of severe ischemic colitis are old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis. […] In this study, the ratio of the involvement of the right colon in the severe group was statistically significant; however, multivariate analysis did not show it to be an independent factor that can influence the severity. […] In conclusion, factors that can predict poor prognosis in ischemic colitis were comorbidity of chronic kidney disease and high ECOG performance status score. Therefore, it is necessary for patients with suspicious ischemic colitis to receive active treatment (e.g., surgery) at an early stage and to be observed carefully if they are treated with chronic kidney disease and if their performance status is poor overall.

• #81 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Currently known prognostic factors of severe ischemic colitis are old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis. […] In this study, the ratio of the involvement of the right colon in the severe group was statistically significant; however, multivariate analysis did not show it to be an independent factor that can influence the severity. […] In conclusion, factors that can predict poor prognosis in ischemic colitis were comorbidity of chronic kidney disease and high ECOG performance status score. Therefore, it is necessary for patients with suspicious ischemic colitis to receive active treatment (e.g., surgery) at an early stage and to be observed carefully if they are treated with chronic kidney disease and if their performance status is poor overall.

• #82 Predictive Factors for Severe Outcomes in Ischemic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15167

  Currently known prognostic factors of severe ischemic colitis are old age, showing hemodynamic instability at an early stage of ischemic colitis, continued colon paralysis, involvement of right colon, medical history of hypertension and malignant tumors, and end-stage renal disease with hemodialysis. […] In this study, the ratio of the involvement of the right colon in the severe group was statistically significant; however, multivariate analysis did not show it to be an independent factor that can influence the severity. […] In conclusion, factors that can predict poor prognosis in ischemic colitis were comorbidity of chronic kidney disease and high ECOG performance status score. Therefore, it is necessary for patients with suspicious ischemic colitis to receive active treatment (e.g., surgery) at an early stage and to be observed carefully if they are treated with chronic kidney disease and if their performance status is poor overall.

• #83

  https://link.springer.com/article/10.1007/s11894-005-0013-1

  Higgins PDR, Davis KJ, Laine L: Systematic review: the epidemiology of ischemic colitis. Aliment Pharmacol Ther 2004, 19:729738. This systematic review carefully analyzes the literature regarding the incidence, prevalence, and risk factors for ischemic colitis. […] Medina C, Vilaseca J, Videla S, et al.: Outcome of patients with ischemic colitis: review of fifty-three cases. Dis Colon Rectum 2004, 47:180184. This retrospective analysis of cases with ischemic colitis suggests that hypertension is the main risk factor. Additionally, the study defines right colon involvement and peripheral vasculopathy as risk factors for severe outcome.

• #84 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] Older patients with risk factors for atherosclerosis are at especially high risk for developing colon ischemia. […] Overall mortality: 4-12% […] Recurrence rate: up to 10% within 5 years […] CMI most commonly occurs in adults 60 years of age.

• #85 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] Older patients with risk factors for atherosclerosis are at especially high risk for developing colon ischemia. […] Overall mortality: 4-12% […] Recurrence rate: up to 10% within 5 years […] CMI most commonly occurs in adults 60 years of age.

• #86 A Population-Based Study of Incidence, Risk Factors, Clinical Spectrum, and Outcomes of Ischemic Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4326614/

  Little is known about progression of ischemic colitis (IC) among unselected patients. We aimed to estimate the incidence, risk factors, and natural history of IC in a population-based cohort in Olmsted County, Minnesota. The age- and sex-adjusted incidence rates of IC nearly quadrupled, from 6.1 cases/100,000 person-years in 1976-1980 to 22.9/100,000 in 2005-2009. The incidence of IC increased over the past 3 decades in a population-based cohort in Minnesota. There is a paucity of epidemiological data derived from review of actual patient medical records, especially on the incidence and risk factors of IC in the general population. The overall annual incidence of IC between 1976 and 2009 was 16 cases per 100,000 person-years. The age-and sex- adjusted incidence of IC nearly quadrupled over the course of 34 years, from 6.1 cases per 100,000 person-years in 1976-1980 to 22.9 per 100,000 person-years in 2005-2009. The rapid rise in incidence of IC over 34 years may have been due to a number of factors, including increasing life expectancy for patients with underlying predisposing chronic diseases, especially atherosclerotic diseases. In our population, IBS was not a risk factor for IC. The five-year survival among IC cases was 58% as compared to 90% in the Olmsted County controls. Age older than 50 years, right-sided colonic involvement, small bowel involvement, COPD and male gender were all independent predictors of mortality.

• #87 A Population-Based Study of Incidence, Risk Factors, Clinical Spectrum, and Outcomes of Ischemic Colitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4326614/

  Little is known about progression of ischemic colitis (IC) among unselected patients. We aimed to estimate the incidence, risk factors, and natural history of IC in a population-based cohort in Olmsted County, Minnesota. The age- and sex-adjusted incidence rates of IC nearly quadrupled, from 6.1 cases/100,000 person-years in 1976-1980 to 22.9/100,000 in 2005-2009. The incidence of IC increased over the past 3 decades in a population-based cohort in Minnesota. There is a paucity of epidemiological data derived from review of actual patient medical records, especially on the incidence and risk factors of IC in the general population. The overall annual incidence of IC between 1976 and 2009 was 16 cases per 100,000 person-years. The age-and sex- adjusted incidence of IC nearly quadrupled over the course of 34 years, from 6.1 cases per 100,000 person-years in 1976-1980 to 22.9 per 100,000 person-years in 2005-2009. The rapid rise in incidence of IC over 34 years may have been due to a number of factors, including increasing life expectancy for patients with underlying predisposing chronic diseases, especially atherosclerotic diseases. In our population, IBS was not a risk factor for IC. The five-year survival among IC cases was 58% as compared to 90% in the Olmsted County controls. Age older than 50 years, right-sided colonic involvement, small bowel involvement, COPD and male gender were all independent predictors of mortality.

• #88 Ischemic colitis caused increased early and delayed mortality | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-018-0193-2

  Ischemic colitis (IC) refers to the inflammation of the colon secondary to vascular insufficiency and ischemia. IC is the most common type of intestinal ischemia with an annual incidence of 15.6 to 17.7 per 100,000. […] The overall mortality rate was 29% (18/63). Six patients (50%) of those operated died. […] Ischemic colitis causes increased mortality rates both in the immediate and late postoperative course. The disease process needs a better understanding in order to tailor the appropriate treatment, especially surgical intervention for those patients who require it.

• #89 Predictive factors of mortality after colectomy in ischemic colitis: an ACS-NSQIP database study | Trauma Surgery & Acute Care Open

  https://tsaco.bmj.com/content/2/1/e000126

  Ischemic colitis is a common and potentially lethal disease of the gastrointestinal tract with high rates of postoperative morbidity and mortality. […] Approximately 14%66% of patients diagnosed with ischemic colitis require surgery,26 with up to two-thirds of these patients undergoing an emergent operation. Postoperative mortality rates are significant, ranging from 5% to over 80%. […] On our analysis of ACS-NSQIP hospitals, patients undergoing emergent colectomy for ischemic colitis had a 30-day postoperative mortality rate of 25.3%. This number lies within range of previously reported rates in smaller sample populations. […] Independent risk factors of mortality after emergent colectomy for ischemic colitis include elderly age, poor functional status, multiple comorbidities, preoperative septic shock, preoperative blood transfusions, preoperative acute renal failure and delay from hospital admission to surgery. Identification of these risk factors may aid surgeons in patient selection for surgery, and making informed decisions with key stakeholders.

• #90 Ischemic colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ischaemic-colitis?ref=binfind.com%2Fweb

  Ischemic bowel is typically a disease of the elderly (age 60 years) where atherosclerotic disease or low flow states are usually the cause. It is rare in younger individuals, where it is more likely to be related to vasculitis or hypercoagulable states. […] Prognosis is variable: resolution without ongoing complications ~50%, persistent colitis ~20%, ischemic stricture ~10%, gangrene or perforation ~20%. […] Occlusive mesenteric infarction (embolus or thrombosis) has a high mortality rate (~90%) compared to non-occlusive ischemia (~10%).

• #91 Intestinal ischemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/intestinal-ischemia/

  Most common type of intestinal ischemia […] Most commonly affects individuals 60 years of age […] 80% of cases are nongangrenous, resolving without surgery […] Isolated right-sided colon ischemia (IRCI): 10-25% of cases […] Older patients with risk factors for atherosclerosis are at especially high risk for developing colon ischemia. […] Overall mortality: 4-12% […] Recurrence rate: up to 10% within 5 years […] CMI most commonly occurs in adults 60 years of age.

• #92 Ischemic Colitis – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/ischemic-colitis

  Ischemic colitis occurs mainly in older adults (60) and is thought to be caused by small-vessel atherosclerosis. […] Approximately 5% of patients have a recurrence.

• #93 Prognosis and follow-up of 135 patients with ischemic colitis over a five-year period

  https://www.wjgnet.com/1007-9327/full/v19/i44/8042.htm

  Ischemic colitis (IC) has been estimated to account for approximately 3 in 1000 of all admissions to tertiary hospitals. In a recent prospective study conducted in 24 Spanish hospitals, IC was the reason for 1.28 per 1000 hospital admissions. According to the literature, the incidence in the general population is of 4.5-9.9 cases per 105 people/year and of 44 per 105 people/year for those above 40 years of age. […] The objective of this study was to assess the prognosis (recurrence and mortality) of our patients with IC after first hospital admission. […] The estimated cumulative recurrence rates at years, 1, 2, 3 and 4/5 were 2.9%, 5.1%, 8.1% and 9.7%, respectively. […] The mortality rate of IC is still high and the recurrence increases with time. In our study, mortality due to IC at the first admission was 5.9% and 7.4% five years later. The overall rates of mortality, including comorbidities were 8.8% and 31.1% respectively.

• #94 Prognosis and follow-up of 135 patients with ischemic colitis over a five-year period

  https://www.wjgnet.com/1007-9327/full/v19/i44/8042.htm

  Ischemic colitis (IC) has been estimated to account for approximately 3 in 1000 of all admissions to tertiary hospitals. In a recent prospective study conducted in 24 Spanish hospitals, IC was the reason for 1.28 per 1000 hospital admissions. According to the literature, the incidence in the general population is of 4.5-9.9 cases per 105 people/year and of 44 per 105 people/year for those above 40 years of age. […] The objective of this study was to assess the prognosis (recurrence and mortality) of our patients with IC after first hospital admission. […] The estimated cumulative recurrence rates at years, 1, 2, 3 and 4/5 were 2.9%, 5.1%, 8.1% and 9.7%, respectively. […] The mortality rate of IC is still high and the recurrence increases with time. In our study, mortality due to IC at the first admission was 5.9% and 7.4% five years later. The overall rates of mortality, including comorbidities were 8.8% and 31.1% respectively.

• #95 Ischemic colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ischaemic-colitis?ref=binfind.com%2Fweb

  Ischemic bowel is typically a disease of the elderly (age 60 years) where atherosclerotic disease or low flow states are usually the cause. It is rare in younger individuals, where it is more likely to be related to vasculitis or hypercoagulable states. […] Prognosis is variable: resolution without ongoing complications ~50%, persistent colitis ~20%, ischemic stricture ~10%, gangrene or perforation ~20%. […] Occlusive mesenteric infarction (embolus or thrombosis) has a high mortality rate (~90%) compared to non-occlusive ischemia (~10%).

• #96 Ischemic colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ischaemic-colitis?ref=binfind.com%2Fweb

  Ischemic bowel is typically a disease of the elderly (age 60 years) where atherosclerotic disease or low flow states are usually the cause. It is rare in younger individuals, where it is more likely to be related to vasculitis or hypercoagulable states. […] Prognosis is variable: resolution without ongoing complications ~50%, persistent colitis ~20%, ischemic stricture ~10%, gangrene or perforation ~20%. […] Occlusive mesenteric infarction (embolus or thrombosis) has a high mortality rate (~90%) compared to non-occlusive ischemia (~10%).

• #97 Ischemic colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ischaemic-colitis?ref=binfind.com%2Fweb

  Ischemic bowel is typically a disease of the elderly (age 60 years) where atherosclerotic disease or low flow states are usually the cause. It is rare in younger individuals, where it is more likely to be related to vasculitis or hypercoagulable states. […] Prognosis is variable: resolution without ongoing complications ~50%, persistent colitis ~20%, ischemic stricture ~10%, gangrene or perforation ~20%. […] Occlusive mesenteric infarction (embolus or thrombosis) has a high mortality rate (~90%) compared to non-occlusive ischemia (~10%).

• #98 Ischemic colitis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ischaemic-colitis?ref=binfind.com%2Fweb

  Ischemic bowel is typically a disease of the elderly (age 60 years) where atherosclerotic disease or low flow states are usually the cause. It is rare in younger individuals, where it is more likely to be related to vasculitis or hypercoagulable states. […] Prognosis is variable: resolution without ongoing complications ~50%, persistent colitis ~20%, ischemic stricture ~10%, gangrene or perforation ~20%. […] Occlusive mesenteric infarction (embolus or thrombosis) has a high mortality rate (~90%) compared to non-occlusive ischemia (~10%).

• #99 Exercised-Induced Ischemic Colitis in a Recreational Athlete Previously Attributed to Inflammatory Bowel Disease | Lukela | Journal of Medical Cases

  https://www.journalmc.org/index.php/JMC/article/view/839/459

  Ischemic colitis traditionally presents in older patients, many whom have underlying atherosclerotic disease. […] Recently, otherwise healthy athletes have been reported to develop ischemic colitis during or following strenuous, prolonged exercise. […] This case highlights the importance of recognizing the diagnosis of ischemic colitis in an atypical host, but one in which the disease prevalence is likely to increase as more individuals participate in recreational endurance activities. […] The prevalence of recreational endurance athletes is increasing rapidly. […] As such, this case highlights the importance of recognizing the diagnosis of ischemic colitis in an atypical host, but one in which the disease prevalence is likely to increase as more individuals participate in recreational endurance activities.

• #100 Exercised-Induced Ischemic Colitis in a Recreational Athlete Previously Attributed to Inflammatory Bowel Disease | Lukela | Journal of Medical Cases

  https://www.journalmc.org/index.php/JMC/article/view/839/459

  Ischemic colitis traditionally presents in older patients, many whom have underlying atherosclerotic disease. […] Recently, otherwise healthy athletes have been reported to develop ischemic colitis during or following strenuous, prolonged exercise. […] This case highlights the importance of recognizing the diagnosis of ischemic colitis in an atypical host, but one in which the disease prevalence is likely to increase as more individuals participate in recreational endurance activities. […] The prevalence of recreational endurance athletes is increasing rapidly. […] As such, this case highlights the importance of recognizing the diagnosis of ischemic colitis in an atypical host, but one in which the disease prevalence is likely to increase as more individuals participate in recreational endurance activities.

• #101 Case Report: Ischemic Colitis in Severe COVID-19 Pneumonia: An Unforeseen Gastrointestinal Complication in: The American Journal of Tropical Medicine and Hygiene Volume 104 Issue 1 (2021)

  https://www.ajtmh.org/view/journals/tpmd/104/1/article-p63.xml

  Ischemic colitis, although the most common ischemic pathology of the GI tract, is relatively rare, occurring as a result of colonic hypoperfusion. The innumerable causes of colonic ischemia are categorized into occlusive and nonocclusive pathologies. […] SARS-CoV-2 has been linked to the development of coagulopathy and thromboembolic complications in severe COVID-19 patients. […] Severe COVID-19 can lead to nonocclusive colonic ischemia, as shock and hemodynamic compromise are common in COVID-19 pneumonia. […] The vibrant clinical presentation and complications of COVID-19 are varied and still emerging. In this case, the rare GI complication of ischemic colitis and its possible causes in COVID-19 are described.

• #102 Case Report: Ischemic Colitis in Severe COVID-19 Pneumonia: An Unforeseen Gastrointestinal Complication in: The American Journal of Tropical Medicine and Hygiene Volume 104 Issue 1 (2021)

  https://www.ajtmh.org/view/journals/tpmd/104/1/article-p63.xml

  Ischemic colitis, although the most common ischemic pathology of the GI tract, is relatively rare, occurring as a result of colonic hypoperfusion. The innumerable causes of colonic ischemia are categorized into occlusive and nonocclusive pathologies. […] SARS-CoV-2 has been linked to the development of coagulopathy and thromboembolic complications in severe COVID-19 patients. […] Severe COVID-19 can lead to nonocclusive colonic ischemia, as shock and hemodynamic compromise are common in COVID-19 pneumonia. […] The vibrant clinical presentation and complications of COVID-19 are varied and still emerging. In this case, the rare GI complication of ischemic colitis and its possible causes in COVID-19 are described.

• #103 Congestive ischemic colitis successfully treated with anti-inflammatory therapy: A case report

  https://www.wjgnet.com/2307-8960/full/v12/i1/142.htm

  Congestive ischemic colitis is a rare subtype of ischemic colitis with an unknown pathophysiology. […] Current literature suggests that anti-inflammatory agents may effectively treat congestive ischemic colitis. […] Congestive ischemic colitis, which is a rare type of ischemic colitis, has no clear pathophysiology or consensus for optimal treatment. […] However, recent reports suggest that anti-inflammatory agents may be effective in treating congestive ischemic colitis. […] The diagnosis of congestive ischemic colitis requires a comprehensive assessment, including the patients symptoms, medical history, and imaging examinations. […] The pathophysiology of congestive ischemic colitis may involve venous ischemia and subsequent reperfusion injury. […] Fasting is the most effective treatment for congestive ischemic colitis that reduces colonic oxygen demand, thereby alleviating the imbalance between arterial supply and venous return. […] However, as reported in this case, the use of anti-inflammatory agents, such as glucocorticoids and 5-aminosalicylate, shows promise and may lead to novel effective therapies.

• #104 Prevalence and predictive value of sarcopenia in hospitalized patients with ischemic colitis | Scientific Reports

  https://www.nature.com/articles/s41598-024-65243-6

  Ischemic colitis (IC) occurs owing to blood flow that is insufficient to maintain the metabolic function of colonocytes and it accounts for 75% of intestinal ischemia. […] Additionally, a population-based cohort study in the United States found that the annual incidence of IC was 16.3 per 100,000 person-years, and it has increased over the past three decades. […] The incidence of IC tends to increase with age, and is associated with various medical conditions, surgical history, and drug usage. […] Identifying poor prognostic factors for IC and determining early intervention would help to improve the outcomes of IC treatment. […] The prevalence of sarcopenia in hospitalized patients with IC differed according to whether it was defined as SMA/BMI (49.3%) or SMA/height2 (34.7%). […] The prognosis of patients with sarcopenia was worse in terms of IC. […] Moreover, sarcopenia was identified as an independent predictor of mortality or surgical intervention. […] These findings suggest the need for meticulous monitoring, prompt medical treatment, and timely surgical consultation, particularly for patients with IC and sarcopenia.

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