| Abstract: | Ischemic colitis usually presents as an isolated event, and clustering seldom occurs. Although a majority of instances of colonic ischemia have no clearly identifiable cause, many kinds of predisposing factors for the occurrence of ischemic colitis are pointed out. These include high age, generalized atherosclerosis, impaired cardiac function, hypovolemia, hypotension, colonoscopy, obstructing colonic cancer, coagulopathies and use of vasoconstrictors or contraceptives. However, infectious viral enterocolitis has not been regarded as a predisposing factor for colonic ischemia. We present here two cases of epidemic enterocolitis presenting as ischemic colitis that occurred almost simultaneously in two compromized long‐term patients in Noda Hospital, Chiba Prefecture. At the time, viral enterocolitis due to Norwalk virus infection was epidemic in Japan, including in the region of the hospital. It is likely that epidemic enterocolitis induced strong gut peristalsis and caused colonic spasm that mediated colonic ischemia. Indeed, both patients were elderly and had prominent signs of atherosclerosis, and one patient suffered from diabetes mellitus. Notably, the physician who performed the rectosigmoidoscopy in the two patients presented with enterocolitis 1 day after the procedure. This indicates that occupational transmission of epidemic enterocolitis can occur in medical staff during endoscopy procedures. |
