Ischemic colitis, also rare, is the most common ischemic pathology of the digestive system. It usually affects the ageing population and those suffering from end-stage renal disease (ESRD), hypertension, and heart failure. Its incidence varies from 4.5 to 44 cases per 100,000 annually.
We have reported a case of gangrenous colitis in a 62-year-old man suffering from acute promyelocytic leukaemia (APL) and myelofibrosis. He had hypertension and ESRD due to obstructive uropathy from seven years ago in his past medical history. His recurrent constitutional symptoms and persistent leukocytosis of more than 20,000 in μL was always treated as catheter-related infection or sepsis until acute abdomen emerged. The surgical team encountered a vast gangrenous right hemicolon. The leukocytosis did not resolve. Thus, the haematological investigations proved APL with myelofibrosis. The affected colon was free of leukemic infiltration.
Ischemic colitis, also rare, is the most common ischemic pathology of the digestive system.
Not every leukocytosis should be viewed as sepsis.
Although rare, acute promyelocytic leukaemia can be accompanied by myelofibrosis.
Ischemic colitis may be a result of a hypercoagulable state caused by leukaemias, not necessarily leukaemic invasion.
The cecum is within a watershed of the colon in which incomplete anastomoses of the marginal arteries make its blood supply poor and vulnerable to ischemia.