Abstract
INTRODUCTION: Ischemic colitis (IC) is one of the most common ischemic disorders of the gastrointestinal tract. Although most cases can be managed conservatively, some progress to the gangrenous form requiring surgical intervention. Emergency surgery for gangrenous IC has typically been performed via laparotomy. CASE PRESENTATION: An 81-year-old woman presented with abdominal pain and hematochezia. She was initially managed conservatively under the diagnosis of IC; however, on hospital day 4, she developed peritoneal signs and a marked increase in inflammatory markers. Contrast-enhanced CT revealed poor enhancement of the splenic flexure and descending colon. Diagnostic laparoscopy confirmed gangrenous IC, and a laparoscopic extended left hemicolectomy with colostomy was performed. The postoperative course was uneventful, and the patient achieved a favorable outcome. CONCLUSIONS: This case highlights that laparoscopic surgery is a safe and effective option for diagnosing and managing gangrenous IC in selected patients.