Prognosis of ischemic colitis: Comparison of color Doppler sonography withearly clinical and laboratory findings

OBJECTIVE, The objective of this study was to compare the value of color Do ppler sonography with early clinical and laboratory findings in determining the prognosis of patients with ischemic colitis. SUBJECTS AND METHODS. We reviewed the early clinical, laboratory, and color Doppler sonographic data of 24 patients with ischemic colitis. The patient s were divided into two groups on the basis of their outcome. The first gro up comprised the patients with transient ischemia who recovered uneventfull y, and the second group included the patients who needed surgery because of symptomatic transmural colic gangrene or colic stricture. Clinical data an d laboratory values were compared with color Doppler sonographic findings i ncluding colic wail thickness, presence of stratification, and arterial how in the bowel wall. RESULTS, At univariate analysis, increased age (p = 0.007), leukocyte count (p = 0.030), lactate dehydrogenase level (p = 0.030), blood lactate level (p = 0.041), and absence of vascular Row in the colic wall (p < 0.001) were significantly related to complicated ischemic colitis. At multivariate ana lysis, absence of arterial Row was the only significant predictor of compli cated ischemic colitis (p = 0.002), with a sensitivity of 82%, a specificit y of 92%, a positive predictive value of 90%, and a negative predictive val ue of 86%. CONCLUSION. Absence of arterial Row in the wall of the ischemic colon on in itial color Doppler sonography is suggestive of an unfavorable outcome and is more closely associated with outcome than early clinical and laboratory findings.