Kolonoskopide İskemik Kolit Tespit Edilen Hastalar ile Deneyimimiz

Öz

Giriş ve Amaç: İskemik kolit (İK) özellikle 60 yaş üstündeki hastalarda alt gastrointestinal kanamanın en sık görülen sebeplerinden biridir. Bu çalışmada kolonoskopide İK tespit edilen hastalarının klinik ve demografik özelliklerini araştırdık. Gereç ve Yöntem: Bu çalışma Ocak 2014-Aralık 2017 tarihleri arasında çeşitli sebeplerle kolonoskopi yapılan hastaların hasta kayıtları incelenerek retrospektif olarak yapılmıştır. Kolonoskopi raporlarında İK ön tanısı olan hastalar çalışmaya alınmıştır. Toplan 130 hasta bulunmuş, 18 hasta veri eksikliği nedeniyle çalışmadan dışlanmış ve çalışma 112 hasta ile yapılmıştır. Bulgular: Kolonoskopide İK ön tanısı olan 112 hastanın 56’sında kesin İK tanısı konulmuştur (%50). Kesin İK tanısı alan hastaların yaş ortalaması 68 olup hastaların 30’u erkek, 26’sı ise kadın idi. İK hastalarının en sık karın ağrısı, hematokezya, ishal ve ateş şikayeti ile hastaneye başvurduğu görülmüştür. İskemik kolitin en sık sol kolonu tuttuğu görülmüştür. İK tanılı hastaların doppler bulgularında hastaların büyük çoğunluğunda tüm mezenter damarlar ve aort normaldi (%70). İK’e sebep olabilecek predispozan faktörler incelendiğinde hastaların %59’unda hipertansiyon, %59’unda koroner arter hastalığı, %21’inde diyabetes mellitus ve %18’inde kalp yetmezliği izlendi. Hastaların büyük çoğunluğu medikal tedavi ile düzelmiştir (%89). 6 hasta kolon rezeksiyonu için cerrahiye verilmiş (%11), bu hastalardan 4’ü iyileşmiş ancak iki hasta yaygın tromboembolik durum ve buna bağlı geniş iskemi nedeniyle exitus olmuştur (%4). Sonuç: İK özellikle predispozan risk faktörlerinin olduğu yaşlı erkek hastalarda kanlı ishal ve karın ağrısı ile semptom veren, sıklıkla sol kolonu tutan ve medikal tedaviye iyi yanıt veren bir hastalık olup akut ishal ve karın ağrısı olan her hastada akla gelmelidir.

Anahtar Kelimeler

• İskemik kolit
• Kolonoskopi
• Alt gastrointestinal kanama
• Kanlı ishal

Our Experience with Patients That Diagnosed Ischemic Colitis in Colonoscopy

Öz

Aim: Ischemic colitis (IC) is one of the most common causes of lower gastrointestinal bleeding, especially in patients over 60 years of age. In this study, we investigated the clinical and demographic characteristics of patients with IC detected by colonoscopy. Material and Method: This study was conducted retrospectively by examining the patient records of patients who underwent colonoscopy for various reasons between January 2014 and December 2017. Patients with IC pre-diagnosis in the colonoscopy reports were included in the study. A total of 130 patients were found, 18 patients were excluded from the study due to lack of data and the study was conducted with 112 patients. Results: Definitive IC was diagnosed in 56 of 112 patients who had a preliminary diagnosis of colonoscopy (50%). The average age of patients diagnosed with definitive IC was 68, of which 30 were male and 26 were female. It was observed that IC patients applied to the hospital with complaints of abdominal pain, hematochezia, diarrhea and fever. It is observed that ischemic colitis is most frequently affects left colon. In the doppler findings of patients with IC, all mesenteric vessels and aorta were normal in the vast majority of patients (70%). When predisposing factors that may cause IC were examined, hypertension was observed in 59% of patients, coronary artery disease in 59%, diabetes mellitus in 21% and heart failure in 18%. The vast majority of patients improved with medical therapy (89%). Six patients were given surgery for colon resection (11%), 4 of these patients recovered, but two patients became exitus due to the common thromboembolic condition and associated extensive ischemia (4%). Conclusion: IC is a disease that presents symptoms such as bloody diarrhea and abdominal pain, especially in elderly male patients with predisposing risk factors, frequently seen in the left colon and responds well to medical treatment, and should be considered in every patient with acute diarrhea and abdominal pain.

Anahtar Kelimeler

• Ischemic colitis
• Colonoscopy
• Lower gastrointestinal bleeding
• Bloody diarrhea

Kaynakça

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