A 67-year-old woman without CVRF, with a history of hysterectomy for myoma, under standard treatment with dexketoprofen and diazepam for myalgia.
He came to the emergency department because of a continuous abdominal pain of 48 hours of evolution, located in mesohypogastric region, with hemorrhagic stools.
She reported no nausea or vomiting or weight loss.
The patient is afflicted.
Physical examination revealed a soft, depressible abdomen, painful to the deep fixation in mesogastrium-hypogastrium, without signs of peritoneal irritation, with presence of air-fluid sounds.
No masses or enlargements.
Laboratory tests showed elevated LDH (236 U/L) with a CRP of 6.07 mg/dL and a CPK of 192 U/L. Hemoglobin was 13.9 g/dL.
There is no leukocytosis or neutrophilia and the coagulation study is normal.
No pathological findings were observed on CT angiography.
The patient is admitted to the General Surgery Service.
The following images are requested:
The loss of objective epi, at the splenic angle level, is characterized by a pattern of approximately 15 cm in length with approximately 25% of the circumference of the colon, consisting of edematous, friable mucosa, with some ero minor.
Pathological examination showed mild corion edema.
No specific ischemic or regenerative changes were observed.
1.
Diagnosis: Ischemic colitis
With the clinical data and the diagnosis of ischemic colitis (IC) in resolution.
Initially an absolute diet, fluid therapy, bemiparin, antibiotic therapy and analgesia were prescribed.
The patient evolved favorably.
Oral tolerance was restarted with no incidents.
At discharge the patient is asymptomatic.
She was referred to the Hematology outpatient service to rule out a situation of malignancy.
