| Summary: | Acute abdomen pain refers to a sudden severe abdomen pain that is less than 24 hours in duration and can be caused by ischemic colitis. Ischemic colitis is an ischemic injury to the colon. Most patients affected are elderly with non-specific symptoms and are easily overlooked. We present a case of an elderly female patient with ischemic colitis, who was initially misdiagnosed. An 83-year-old woman had a history of uremia with dialysis, peripheral arterial occlusive disease, atrial fibrillation without medical control, and rectal cancer (post operation of partial proctectomy with right nephrectomy). She visited our emergency room because of acute abdominal pain including bloodied stool passage lasting for one day. Physical examination of the abdomen showed diffuse tenderness. Laboratory tests showed leukocytosis, hyperamylasemia, and poor renal function. Abdominal computed tomography showed mural thickening with peri-focal stranding in the exhausted descending and sigmoid colon. Ischemic colitis was suspected, but the surgeon hesitated to initiate surgery due to non-specific symptoms. Finally, colonoscopy demonstrated segmental edematous, fragile mucosa with scattered erosions and ulcerations from the rectum to the splenic flexure of the colon. Ischemic colitis of the descending colon, sigmoid colon and upper rectum was proved after surgery. The patient’s condition improved after prompt surgery.
|
|---|
