Ischaemic colitis: two distinct patterns of severity.

Ischaemic colitis: two distinct patterns of severityIschaemic colitis accounts for only a small percentage (1 to 2%) ofpatients with colonic pathology seen in gastrointestinal and surgical wards.Because its presentation is non-specific and as numerous conditions may favour its development, ischaemic colitis is probably frequently misdiagnosed and its incidence underestimated.At presentation, the severity ofearly stage disease may vary considerably with the prevalent benign 'transient' forms being amenable to conservative regimens and the severe 'gangrenous' forms, requiring surgery.'5The percentage of surgical cases in a given series ranges widely (from 26 to 42%).7These differences have been referred to repeatedly248 since the key report by Marston et al in 1966 (these authors also specify a third category, ischaemic stricture; however, this will not be dealt with here because, even ifit does exist,9 it will only be diagnosed at a later date).'This review covers diagnosis, predisposing factors, lesion distribution, treatment, and results.It is based on reports (in the literature) and our own six year series of 34 patients of which 13 were treated surgically and 21 conservatively.99