Clinical Study Of 462 Cases Of Ischemic Bowel Disease

Purpose:To analyze and summarize the clinical and laboratory characteristics and prognosis of acute mesenteric ischemia(AMI)and aged ischemic colitis(IC)patients in order to improve AMI and aged IC diagnosis and treatment.Methods:The medical records of 196 patients with acute mesenteric ischemia and 266 patients with aged ischemic colitis diagnosed at 18 domestic hospitals from 2011 to 2013 were reviewed and analyzed retrospectively.Results:Among the total 196 AMI cases,50.00%of them were at the age ranging from 18 to 59,and 42.35%were older than 60 years.There were more male than female patients(59.69%vs 40.31%,P<0.05).The most common symptoms were abdominal pain(164/196),vomiting(109/196),nausea(96/196),abdominal distension(78/196),intestinal obstruction(61/196),gastrointestinal bleeding(50/196),fatigue(28/196),fever(27/196),and diarrhea(24/196).The observed abnormal biochemical values included in D-dimer(99/113),prothrombin time(122/181),elevated white blood cell count(111/118),positive occult test(74/196),and hypoproteinemia(105/196).The possible high risk factors were history of abdominal surgery(60/196),hypertension(40/196),and cardio-cerebrovascular disease(40/196).Before diagnosis,102 cases received abdominal CT examination,and 58 received ultrasonography.There were 113 cases undergoing surgical treatment,20 cases intervention therapy,and 63 cases drug treatment.Among the total 266 aged IC cases,Male patients were 32.71%and female were 67.29%.The common symptoms were gastrointestinal bleeding84.59%(255/266),abdominal pain75.19%(200/266),diarrhea29.7%(79/266),nausea20.68%(55/266),vomit18.8%(50/266),bloating10.53%(28/266),fatigue10.53%(28/266),fever5.64%(15/196).The abnormal biochemical values in all cases were abnormal D-dimer77.59%(90/166),Positive fecal occult blood test68.81%(150/218),abnormal Prothrombin time60.16%(148/246).The possible high risk factors include a history of hypertension46.24%(123/266),and cardia-cerebrovascular disease28.2%(75/266).Colonoscopy were 259 people,accounting for 97.37%of all cases.Medical treatment accounted for 99.25%.Conclusion:AMI is more common in males,at different age groups,but the proportion of non-elderly larger than the elderly.Its main manifestations are abdominal pain,vomiting,nausea,abdominal distension,gastrointestinal bleeding,and intestinal obstruction,etc.We should constantly pay attention to the patients with risk factors,such as history of abdominal surgery,hypertension,cardio-cerebrovascular disease and diabetes for the occurrence of acute mesenteric ischemia.Spiral CT angiography and abdominal ultrasonographic examinations should be performed as early as possible to diagnose the disease definitely.Aged IC in females wasmuch more than that in males.The common symptoms include gastrointestinal bleeding,abdominal pain,diarrhea,vomiting,nausea,vomit,bloating,fatigue,fever etc.We should constantly pay attention to the patients with the above symptoms,especially to those with risk factors.For early diagnosis and treatment,doctors should give the patients colonoscopy and biopsy as soon as possible.