S3990 Ischemic Mass Due to Bowel Preparation

Introduction: Ischemic colitis occurs due to reduced blood flow to the colon. This causes insufficient levels to sustain cellular metabolic function, resulting in mucosal inflammation, ulceration and hemorrhage. The severity and extent can vary causing a wide range of symptoms from mild discomfit to acute abdominal pain and shock. This case illustrates the healing process of ischemic colitis as manifested by a colon mass that may have been caused by her bowel preparation. Case Description/Methods: A 63-year-old woman underwent outpatient colonoscopy with sutab bowel preparation for history of colon polyps and family history of colon cancer. On the day of the colonoscopy she did not report any acute gastrointestinal symptoms. She was found to have a non-obstructing ulcerated mass at her ileocecal valve concerning for malignancy. Biopsies were obtained and a computed tomography angiography abdomen and pelvis were ordered, which was performed 6 days later and unremarkable. Her biopsies result showed as ischemic colitis. Because of this atypical presentation a repeat colonoscopy was performed and showed complete healing of the ulcerated mass. Discussion: Ischemic colitis occurs due to reduced blood flow to the colon. This causes insufficient levels to sustain cellular metabolic function, resulting in mucosal inflammation, ulceration and hemorrhage. The severity and extent can vary causing a wide range of symptoms from mild discomfit to acute abdominal pain and shock. This case illustrates the healing process of ischemic colitis as manifested by a colon mass that may have been caused by her bowel preparation. A notable finding of this patient with ischemic colitis is the endoscopic appearance resembling a colon mass and no gastrointestinal symptoms. This finding is uncommon and can easily lead to misdiagnosis.