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Chronic ischaemic colitis in a 48 year old man: an unusual presentation.

ABSTRACT: Ischaemic colitis typically presents with an acute abdominal pain and distension with bloody diarrhoea. However, this can vary and the condition is frequently missed or misdiagnosed, especially if the patient presents with chronic symptoms. Herein, we report a case of chronic presentation of ischaemic colitis in a 48-year-old man with a history of myocardial infarction. This report highlights the importance of having ischaemic colitis as a differential diagnosis whenever a patient with a history of arteriosclerosis presents with atypical chronic abdominal pain.

SUBMITTER: Lau K

PROVIDER: S-EPMC3693367 | biostudies-other | 2013 Jun

REPOSITORIES: biostudies-other

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Project description:IntroductionVictims of severe hypothermia and cardiac arrest may appear dead. They are often unresponsive to on-scene resuscitation including defibrillation while profoundly hypothermic. Several cases of extreme hypothermia and prolonged cardiac arrest with good outcome have been published. We present a case of heart rate monitored (by pulse-watch) hypothermia, prolonged cardiac arrest and survival with complete recovery of neurological functions.Case presentationOn December 22nd 2007 a physically fit, ethnic Norwegian 48-year-old male kayaker set out to paddle alone around an island in a Norwegian fjord. 3 hours 24 min into his trip the kayak capsized in 3.5 degrees C seawater about 500m from the closest shore. The accident was not observed. He managed to call for help using his cellular phone. After a search and rescue operation he was found by our air ambulance helicopter floating, prone, head submerged, with cardiopulmonary arrest and profound hypothermia. He was wearing a personal heart rate monitor/pulse watch. Following extraction, he received cardiopulmonary resuscitation during transport by air ambulance helicopter to hospital. He was warmed on cardiopulmonary bypass from 20.6 degrees C core temperature and return of spontaneous circulation was achieved 3h 27 m after cardiac arrest occurred. After 21 days of intensive care he was discharged from hospital 32 days after his accident. Testing revealed normal cognitive functions one year after the incident. He has returned to his job as an engineer, and has also taken up kayaking again. We provide heart rate and time data leading up to his cardiac arrest.ConclusionHypothermia has well established neuro-protective effects in cardiac arrest, as our case also shows. Simple cardiopulmonary resuscitation without use of drugs or defibrillation, should be continued until the patients can be re-warmed, preferably using cardiopulmonary bypass. This approach can be highly effective even in seemingly lost cases.

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Chronic ischaemic colitis in a 48 year old man: an unusual presentation.

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