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Systematic review of the management of ischaemic colitis
Author(s) -
O’Neill S.,
Yalamarthi S.
Publication year - 2012
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2012.03171.x
Subject(s) - medicine , systematic review , cochrane library , medline , critical appraisal , colitis , surgery , intensive care medicine , meta analysis , alternative medicine , pathology , political science , law
Aim The study reviews the literature related to ischaemic colitis (IC) to establish an evidence base for its management and to identify factors predicting severity and mortality. Method A systematic review of the English language literature was conducted according to recommendations of the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) statement. MEDLINE, Embase and Cochrane Library databases were searched using the keyword search ‘ischaemic colitis OR colon ischaemia OR colonic ischaemia OR management ischaemic colitis’. IC is often misdiagnosed so only studies where the diagnosis was supported by histopathology in every case were included. Critical appraisal was performed of included studies using predefined quality assessment checklists and narrative data synthesis. Results In all, 2610 publications were identified. Of these, eight retrospective case series and three case controlled studies describing 1049 patients were included. Medical management was used in 80.3% patients of whom 6.2% died. Surgery was required in 19.6% of whom 39.3% died. The overall mortality of IC was 12.7%. Lack of rectal bleeding, peritonism and renal dysfunction were commonly quoted predictors of severity; however, right sided IC appeared to be the most significant predictor of outcome. Conclusion Most patients with IC can be managed conservatively. Right sided IC may be the most significant predictor of severity.