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Ischemic colitis is inflammation of the intestine (colitis) caused by inadequate blood supply (ischemia) to meet the metabolic demands.Textbook
Aetiology
Non-occlusive ischemia
In hemodynamic instable patients (i.e. shock ) the mesenteric perfusion may be compromized. This condition is commonly asymptomatic, and usually only apparent through a systemic inflammatory response. Mortality is roughly 70%Occlusive ischemia
Mostly the result of a thromboembolism of the arteria mesenterica superior or the venae mesenterica (rare). Commonly the embolism is caused by atrial fibrillation, valvular disease, myocardial infarction, or cardiomyopathy.Signs and symptoms
Signs and symptoms of ischemic colitis may be subtle but can include altered mental state, severe abdominal pain, fever, tachycardia, vomiting, bloody diarrhea, and septic shock.
Diagnosis
Computed Tomography is very useful in evaluating patients for enteric ischemia, but also in strangulation complicated closed-loop intestinal obstruction. Imaging is more reliable when used as transmural necrosis has developed. Should the findings remain non-specific one could perform angiography which is considered the best tool for diagnosing mesenteric ischemia. When colonic ischemia is suspected endoscopic evaluation is the preferred method.
Treatment
Non-occlusive ischemia is treated by maintaining blood pressure to ensure adequate perfusion and oxygenation of the gut. Acute occlusive ischemia requires urgent surgery.
Reference
External link
"Ischemic colitis"