Background and Aims: Ischemic colitis (IC) is a common type of ischemic bowel disease, and is also a condition with difficult clinical diagnosis. The early misdiagnosis rate is high, and some patients will rapidly deteriorate after onset, with high associated mortality. This study was conducted to summarize and analyze the clinical characteristics of IC, so as to provide a reference for the its diagnosis and treatment in clinical practice. 
Methods: The clinical data of 101 IC patients treated in Xiangya Hospital of Central South University from January 2010 to September 2019 were reviewed. The general features, clinical manifestations, endoscopic findings and outcomes of the patients were analyzed, and the clinical characteristics between different age groups of patients were also compared. 
Results: All patients had the first onset of IC, of whom, 62 cases (61.4%) were females; age ranges from 45 to 93 years old, with an average age of (63±8.8) years, and with age of 45 to <60 years in 39 cases (middle-age group) and ≥60 years in 62 cases (old-age group). The main symptoms of the patients were hematochezia, lower abdominal pain, nausea and abdominal distension. The main colonoscopic findings were mucosal erythema, edema, vascular pattern abnormalities, erosion and ulceration. Left colon involvement was found in 69 cases (68.3%), right colon involvement was found in 7 cases (6.9%), and extensive colon involvement was in 25 cases (24.8%), respectively. Eighty-one patients (80.2%) underwent abdominal vascular examination, of whom, vascular stenosis or thrombosis formation was detected in 25 cases (30.9%), simple arteriosclerosis was noted in 14 cases (17.3%) and 42 cases (51.8%) showed no obvious abnormity. Most of the patients received conservative medical treatment only, the time for symptom relief was 1 to 35 d, with an average time of (9.5±4.3) d. There were no significant differences in sex composition, location of colon involvement, time for main symptom relief, and total cure rates between old-age group and middle-age group (all P>0.05); the proportions of cases with history of hypertension, coronary heart disease and cerebral vascular disease were higher, and the proportions of cases with stenosis and arteriosclerosis of celiac arteries in old-aged group were higher than those in middle-age group (all P<0.05).
Conclusion: IC occurs frequently in elderly individuals, with a high prevalence in women. The main symptoms are lower abdominal pain and blood in stool, and the left colon is the most affected location. Timely colonoscopy is helpful for making definite diagnosis of IC. Currently, the main treatment modality for IC is conservative treatment based on internal medicine. Elderly IC patients always have underlying health conditions, with poor abdominal vascular conditions, for whom, correct diagnosis as well as early diagnosis and treatment are important for improving the prognosis.