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[Ischemic colitis in young adults.].

INTRODUCTION
Ischemic colitis is most often considered a disease of the elderly with associated cardiovascular disease. Young patients with this disease have been diagnosed at our hospital and therefore the authors decided to investigate the disease's prevalence, its anatomical location, prognosis and risk factors in the young population.


MATERIAL AND METHODS
A retrospective search of all cases diagnosed as ischemic colitis from 01.01. 1983 to 31.12. 1995 was performed. One author (ThornThorn) reviewed all pathological material. Strong inclusion criteria were proposed and of the 50 cases discovered, only 26 fulfilled these strict criteria, 16 women and 10 men. Five were under the age of 40 (19%), three of them men.


RESULTS
Ischemia was most common in the left colon. Incidence has increased in the last years, paralelling the increase in colonoscopies performed. All patients under 40 years of age had completely reversible ischemia, however eight of 21 patients over the age of 60 required surgical intervention. Five patients died and were all older than 75 years. The percentage of young patients is noteworthy.


CONCLUSION
Pathophysiology of ischemic colitis in young people is in most cases unknown. Possible contributing factors in our study were smoking, dehydration, NSAID (non-steroidal anti-inflammatory drugs) use, constipation and contraceptive use. The study supports the importance of early endoscopy and biopsies for diagnosis in patients presenting acutely with symptoms of hemorrhagic colitis.