Chronic ischemic colitis mimicking Crohn's disease: A case report

Ischemic colitis can present a wide spectrum of severity; most patients are mild to moderate in clinical course and can be treated supportively and expected to recover fully, while a minority with severe ischemia may develop long term complication such as stricture or chronic ischemic colitis. Chronic ischemic colitis may lead to chronic ulcerations in segments of colon and separated by normal-appearing mucosa, mimicking Crohn's disease. Here we present a case of 59-year-old female who has multiple comorbid presented with progressive abdominal pain associated with diarrhea and rectal bleeding. Colonoscopy showed severely inflamed severe stricture at the hepatic flexure. Right hemicolectomy was performed and surgical pathology confirmed chronic ischemic colitis. Raising awareness of this disease entity and having a high index of suspicion, especially in the setting of elder patients presenting with abdominal pain, rectal bleeding, and existence of comorbid status is crucial to establish an early diagnosis.