Ischemic colitis. Comparison of surgical and nonoperative management.

A retrospective review of 18 patients with ischemic colitis is presented. Patients who developed ischemic colitis following abdominal aortic surgery were excluded, as were patients in whom the diagnosis was made on clinical grounds only. The diagnosis was confirmed in each case either by proctosigmoidoscopy, colonoscopy, barium enema, surgery, or autopsy. Nine patients were treated surgically and nine nonoperatively. The mortality in the operated group was 55 per cent, compared to a 45 per cent mortality in the nonsurgically managed patients. Successful treatment of ischemic colitis depends on early recognition, which requires a high index of suspicion for this common but frequently unrecognized entity.