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Ischaemic colitis is commonly encountered in elderly patients and the underlying vascular insufficiency may be due to non-occlusive causes such as hypotension and occlusive aetiologies such as mesenteric artery thrombosis or embolism. We report an unusual case of ischaemic colitis due to an angiodestructive peripheral T cell lymphoma.
A patient with hypertension, ischaemic heart disease, atrial fibrillation and recurrent strokes was admitted for acutely worsening abdominal distension and breathlessness. There was a history of persistent abdominal distension and diarrhoea, which were treated conservatively. Endoscopy done had shown reflux oesophagitis, peptic ulceration and right-sided ischaemic colitis. Per-rectal examination revealed blood clots mixed with mucus. CT of the abdomen and pelvis showed no evidence of mesenteric vascular occlusion or masses.
The patient subsequently became hypotensive and underwent emergency laparotomy. Intraoperatively, ischaemic changes of left colon and patchy oedema of the mesentery were noted. …