关键词: 缺血性结肠炎, 结肠镜, 误诊, 手术

Abstract: Objective To investigate the clinical manifestations, diagnosis and treatment of ischemic colitis (IC), and to analyze the misdiagnosis factors.
Method From January 2017 to September 2019,17 IC patients were reported and analyzed for their clinical features and diagnosis and treatment process.Except for 2 patients with peritonitis who did not undergo colonoscopy and underwent surgical operation,all the others whose condition was stable were diagnosed by early colonoscopy.15 patients were treated with anti-inflammatory,diet control,circulatory improvement,anticoagulation and fluid supplementation.The other 2 patients with peritonitis received surgical treatment,1 of whom underwent resection of the right half colon due to intestinal necrosis and recovered successfully after opration;Another patient was found with poor intestinal blood supply and scattered serous membrane necrosis during the operation.The family member refused to undergo intestinal resection and received abdominal drainage.The patient recovered with postoperative drug therapy.
Results All patients were middle-aged and elderly,more female than male,most of them were with diabetes,hypertension,coronary heart disease,hematological system diseases and other underlying diseases.All  patients had recovered and been released from hospital,with an average of two weeks in hospital.In the follow-up,except for 2 chronic patients,recurrence was not observed in the rest of the drug prevention.
Conclusion The middle-aged and the elderly,especially with the underlying diseases,should be vigilant the IC,if the abdominal pain,diarrhea,blood in the stool were appeared,and stable patients should be diagnosed early by colonoscopy.However,for patients with recurrent peritonitis,the rate of misdiagnosis is high,and early surgical treatment should be taken to patient with intestinal necrosis and perforation to reduce the mortality rate.

Key words: ischemic colitis, coloscope, misdiagnose, operation