In general, ischemic colitis has a very good prognosis.
However, there is concern that when ischemia affects the right side of the colon in an isolated fashion, the prognosis may not be so favorable.
Dr Lawrence Brandt and colleagues from New York, USA compared the clinical features and outcomes of ischemia isolated to the right side of the colon with those of ischemia involving other areas of the colon.
|26% were isolated to the right side|
|The American Journal of Gastroenterology|
The team conducted a retrospective study of patients with colon ischemia hospitalized from 1998 to 2005.
Patients were identified using computerized searches of ICD-9 codes for colon ischemia.
The patients were divided into those with isolated right colon ischemia, and those with colon ischemia not involving the right colon in an isolated fashion.
Only patients with biopsy-proven ischemic colitis were entered into the study.
The researchers identified 273 cases of biopsy-proven ischemic colitis.
The team noted that 26% were isolated to the right side.
Of these isolated right colon ischemia cases, 59% had an unfavorable outcome compared with 17% of cases of non-isolated right colon ischemia .
The team noted that 55% of isolated right colon ischemia patients required surgery compared with 11% of non-isolated right colon ischemia patients.
Mortality in patients with isolated right colon ischemia was 23% compared with 12% in patients with non-isolated right colon ischemia.
Dr Brandt's team concluded, "A total of 273 cases of biopsy-proven ischemic colitis were identified of which 26% involved only the right side."
"Patients with isolated right colon ischemia had a worse outcome than those with colon ischemia involving other colon regions, including a 5-fold need for surgery and a 2-fold mortality."