Ischemic colitis has a clinical spectrum ranging from mild reversible colitis to an acute fulminant course. Early and accurate diagnosis is therefore mandatory for a good clinical outcome. The aim of this study is to evaluate the efficacy and safety of a colonoscopy and histological examination with biopsy in the early and accurate diagnosis of ischemic colitis.

We investigated the clinical characteristics and endoscopic findings with the histopathology of 89 cases of ischemic colitis from October 2002 to August 2012 in a tertiary-care hospital. All patients underwent a colonoscopy with biopsy within a few days of the onset of symptoms, and the histological features from the biopsy specimens were reviewed. In addition, the occurrence of complications by colonoscopy with biopsy was evaluated.

The mean age of the patients was 65.8±12.6 years (male:female, 1:2.2). The major combined disorders were hypertension (51.7%), diabetes (31.5%), and arrhythmia (19.1%). The clinical features usually presented with hematochezia (83.1%), abdominal pain (77.5%), and diarrhea (60.7%). The involved patterns were the left colon (56.2%), right colon (39.3%), and pancolon (4.5%). Based on the main histological features of ischemic colitis, including glandular atrophy (67.4%), hemorrhage (61.8%), capillary thrombi (42.7%), and coagulative necrosis of mucosa (29.2%), 67 of the 89 cases (75.3%) could be confirmed with ischemic colitis. There were no serious complications such as bowel perforation or major bleeding following the colonoscopy with biopsy.

A colonoscopy with biopsy is beneficial and safe for the early and precise diagnosis of ischemic colitis.