Spontaneous Ischaemic Proctocolitis

Abstract

Twenty cases of spontaneous large bowel ischaemia, which presented during an 8-year period, are reviewed. These included one patient with involvement of the right side of the colon, and one with a recto-sigmoid lesion. The preponderance of females affected runs contrary to the usual sex incidence of generalized vascular disease. Two of the 20 patients developed recurrent episodes of ischaemia. In view of the rapid resolution in many cases, the importance of early plain X-ray, sigmoidoscopy, and barium enema is stressed. Conservative management is sufficient in the majority of cases, surgery being reserved for the rarer gangrenous variety, and where either a tight stricture or doubtful diagnosis presents a problem. Spontaneous ischaemic proctocolitis carries a low mortality, except where gangrene is a feature.

Key-words:

• Colitis
• colon
• gangrene
• ischaemia
• proctitis
• stricture