Acute ischemic colitis - mild form - Example 2
This 73-year-old male had been treated for squamous cell carcinoma of the parotid region. During his inpatient hospitalization he developed abdominal pain and watery diarrhea. A few hours later, he passed bright red blood with his bowel movement. Ultrasound identified a 10-cm segment of the descending colon with wall thickening and a filiform lumen.
The caecum, ascending and transverse colon are unremarkable. The video begins in the vicinity of the splenic flexure. There are areas of edematous mucosa with erythema and loss of vascular structure. Somewhat further distalwards there are circumferential changes with erythematous, thickened mucosa with fibrin deposits. The lumen is severely narrowed. In the distal descending colon the changes end with a sharp border to normal mucosa.
Histology confirmed the segmental, ulcerous and partially necrotizing colitis. Colonoscopy was performed two days after onset of clinical symptoms. The changes with erythema, edema and flat necrotic areas are part of the early stage of the disease.