PDF(Pubmed)
Abstract：
BACKGROUND: Congestive ischemic colitis is a rare subtype of ischemic colitis with an unknown pathophysiology. Excluding conservative management, such as fasting, no established treatment exists; therefore, surgical intervention should be considered in some cases if symptoms worsen. Current literature suggests that anti-inflammatory agents may effectively treat congestive ischemic colitis.
METHODS: We present the case of a 68-year-old female patient who underwent laparoscopic left hemicolectomy for transverse colon cancer 3 years ago. Postoperatively, follow-up included an annual colonoscopy and abdominal computed tomography (CT) at a local clinic. However, progressive erythema and edema of the sigmoid colon were observed 1 year postoperatively. Upon admission to our hospital, she complained of abdominal pain and diarrhea. Abdominal CT showed thickening of the sigmoid colon walls, and colonoscopy revealed erythema, edema, and multiple ulcers with exudate in the sigmoid colon. CT angiography showed engorgement of the sigmoid vasa recta without any vascular abnormalities. The diagnosis was congestive ischemic colitis, and we treated the patient with anti-inflammatory agents. After 2 mo of glucocorticoid therapy (20 mg once daily) and 7 mo of 5-aminosalicylate therapy (1 g twice daily), the ulcers completely healed. She has not experienced any recurrence for 2 years.
CONCLUSIONS: Anti-inflammatory therapy, specifically glucocorticoids and 5-aminosalicylate, has demonstrated promising efficacy and introduces potential novel treatment options for congestive ischemic colitis.
METHODS: We present the case of a 68-year-old female patient who underwent laparoscopic left hemicolectomy for transverse colon cancer 3 years ago. Postoperatively, follow-up included an annual colonoscopy and abdominal computed tomography (CT) at a local clinic. However, progressive erythema and edema of the sigmoid colon were observed 1 year postoperatively. Upon admission to our hospital, she complained of abdominal pain and diarrhea. Abdominal CT showed thickening of the sigmoid colon walls, and colonoscopy revealed erythema, edema, and multiple ulcers with exudate in the sigmoid colon. CT angiography showed engorgement of the sigmoid vasa recta without any vascular abnormalities. The diagnosis was congestive ischemic colitis, and we treated the patient with anti-inflammatory agents. After 2 mo of glucocorticoid therapy (20 mg once daily) and 7 mo of 5-aminosalicylate therapy (1 g twice daily), the ulcers completely healed. She has not experienced any recurrence for 2 years.
CONCLUSIONS: Anti-inflammatory therapy, specifically glucocorticoids and 5-aminosalicylate, has demonstrated promising efficacy and introduces potential novel treatment options for congestive ischemic colitis.
摘要：
背景：充血性缺血性结肠炎是一种罕见的缺血性结肠炎亚型，其病理生理学未知。不包括保守的管理，比如禁食，没有既定的治疗方法；因此，在某些情况下，如果症状恶化，应考虑手术干预。目前的文献表明抗炎药可以有效治疗充血性缺血性结肠炎。
方法：我们介绍了一例68岁女性患者，该患者在3年前接受了腹腔镜左半结肠切除术治疗横结肠癌。术后,随访包括每年在当地诊所进行的结肠镜检查和腹部计算机断层扫描(CT).然而,术后1年观察到乙状结肠进行性红斑和水肿。入院后，她抱怨腹痛和腹泻。腹部CT显示乙状结肠壁增厚，结肠镜检查发现红斑，水肿,乙状结肠有多个溃疡伴渗出物。CT血管造影显示乙状血管直肠充盈，无任何血管异常。诊断为充血性缺血性结肠炎,我们用抗炎药治疗病人.经过2个月的糖皮质激素治疗（20毫克，每日一次）和7个月的5-氨基水杨酸盐治疗（1克，每日两次），溃疡完全愈合。她已经两年没有复发了。
结论：抗炎治疗，特别是糖皮质激素和5-氨基水杨酸，已经证明了有希望的疗效，并为充血性缺血性结肠炎引入了潜在的新治疗选择。
方法：我们介绍了一例68岁女性患者，该患者在3年前接受了腹腔镜左半结肠切除术治疗横结肠癌。术后,随访包括每年在当地诊所进行的结肠镜检查和腹部计算机断层扫描(CT).然而,术后1年观察到乙状结肠进行性红斑和水肿。入院后，她抱怨腹痛和腹泻。腹部CT显示乙状结肠壁增厚，结肠镜检查发现红斑，水肿,乙状结肠有多个溃疡伴渗出物。CT血管造影显示乙状血管直肠充盈，无任何血管异常。诊断为充血性缺血性结肠炎,我们用抗炎药治疗病人.经过2个月的糖皮质激素治疗（20毫克，每日一次）和7个月的5-氨基水杨酸盐治疗（1克，每日两次），溃疡完全愈合。她已经两年没有复发了。
结论：抗炎治疗，特别是糖皮质激素和5-氨基水杨酸，已经证明了有希望的疗效，并为充血性缺血性结肠炎引入了潜在的新治疗选择。
