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The patient was an 82-year-old woman who visited her previous physician for abdominal pain and was urgently admitted to the hospital with a diagnosis of ischemic enteritis. The next day, her abdominal pain increased, and she was transferred to our hospital. When she came to our hospital, her vital signs were stable and tenderness with muscular defense was observed in the entire abdomen. The contrast-enhanced CT scan of the abdomen by the previous physician showed that poor contrast enhancement in the entire colon, and no thrombus in the mesenteric vessels was noted. A diagnosis of ischemic colitis with necrosis of the entire colon was made, and emergency surgery was performed. The abdomen was opened through a median incision, and necrosis of the ascending colon to the sigmoid colon was observed. Total colon resection was performed, and a single-hole ileostomy was constructed. The patient was discharged home 38 days postoperatively. Necrotic ischemic colitis is infrequent, and necrosis of the entire colon has a high mortality rate and a poor prognosis. The survival rate is significantly reduced after 24 hours from the onset of the disease, and so surgery should be performed as soon as possible if the disease is suspected. [ABSTRACT FROM AUTHOR]