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Ischemic colitis is a transient reduction in blood flow to the colon.
Necrosis may occur but is usually limited to the mucosa and submucosa, only occasionally causing full-thickness necrosis necessitating surgery. It occurs mainly in older people (> 60) and is thought to be caused by small-vessel atherosclerosis.
Symptoms are milder and of slower onset than those of acute mesenteric ischemia and consist of left lower quadrant pain followed by rectal bleeding. Diagnosis is made by colonoscopy; angiography or magnetic resonance angiography is not indicated. Treatment is supportive with IV fluids, bowel rest, and antibiotics. Surgery is rarely required. About 5% of patients have a recurrence. Occasionally, strictures develop at the site of the ischemia several weeks later, necessitating surgical resection.
Last full review/revision September 2007 by Parswa Ansari, MD
Content last modified September 2007
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