A Case of Stricture-Type Ischemic Colitis Successfully Treated by Continuous Intravenous Infusion of Prostaglandin E1.

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• A 75-year-old male was admitted to our hospital because of sudden bloody diarrhea after enema on October 24, 1998. The initial colonoscopy disclosed a longitudinal deep ulcer with circular inflammation in the sigmoid colon and a marked narrowing of the lumen. Barium enema showed poor distension and mucosal irregularity with thumb-printing extending from the splenic flexure to the sigmoid colon. Mucosal biopsy revealed typical findings of ischemic colitis. After a month barium enema demonstrated a severe stricture (8mm in diameter of the lumen) at the SD junction and colonoscopy disclosed active inflammation with a longitudinal open ulcer in the sigmoid colon. We made a diagnosis of ischemic colitis of the stricture type. Despite conservative treatment for over 2 months, the stricture remained to be unchanged. He underwent a trial of continuous intravenous infusion of prostaglandin E<SUB>1</SUB> (80μ/day) for a total of 5 weeks under the condition of intravenous hyperalimentation. Subsequent colonoscopy showed considerable improvement of severe stenosis with healed scar of the longitudinal ulcer. Barium enema performed 5 months after the treatment revealed that the stricture had been improving up to 23mm in diameter of the lumen. It is suggested that the infusion therapy of prostaglandin E<SUB>1</SUB> is an effective conservative treatment for ischemic colitis of the stricture type, and should he cosidered before surgical treatment.

• 社団法人 日本消化器内視鏡学会の論文

社団法人 日本消化器内視鏡学会 | 論文

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