Hai-Bo Zhou
Background: The data of 21 cases of ischemic colitis, including 20 cases in previous reports and one case in this study, were reviewed and incorporated into comprehensive analysis.
Case presentation: Ischemic colitis occurred in 3-48 hours after colonoscopy in all patients, with the clinical manifestations of abdominal pain, diarrhea, bloody stools, and increased D-dimer levels. Endoscopic findings were mostly transient. The control measures included: reduced gas injection during examination, and timely withdrawal if excessive gas was injected; gentle operation and proper force used to maintain the colonoscope while retracting tissues; examination performed under intravenous anesthesia for nervous and anxious patients; blood volume supplement during intestinal preparation; and strict implementation of the rules for sterilization of colonoscopy.
Conclusion: Colonoscopy can lead to ischemic colitis, which should be brought to attention of endoscopists. For patients with ischemic colitis after colonoscopy, a second colonoscopy should be performed as soon as possible for diagnosis and timely treatment.
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