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Ischemic Colitis

By

Parswa Ansari

, MD, Hofstra Northwell-Lenox Hill Hospital, New York

Last full review/revision Sep 2021| Content last modified Sep 2021
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Ischemic colitis is a transient reduction in blood flow to the colon. Diagnosis is by CT or colonoscopy. Treatment is supportive with IV fluids, bowel rest, and antibiotics.

Symptoms of ischemic colitis are milder and of slower onset than those of acute mesenteric ischemia Symptoms and Signs Acute mesenteric ischemia is interruption of intestinal blood flow by embolism, thrombosis, or a low-flow state. It leads to mediator release, inflammation, and ultimately infarction. Abdominal... read more Symptoms and Signs and consist of left lower quadrant pain followed by rectal bleeding. The pathophysiology and treatment of the two conditions are quite different.

Diagnosis of Ischemic Colitis

  • CT or colonoscopy

Diagnosis of ischemic colitis is made by CT or colonoscopy.

Angiography or magnetic resonance angiography is not indicated.

Treatment of Ischemic Colitis

  • IV fluids, bowel rest, and antibiotics

  • Rarely surgery

Treatment of ischemic colitis is supportive with IV fluids, bowel rest, and antibiotics.

The underlying cause of the low-flow state (eg, control of cardiac arrhythmia) is treated if relevant.

Surgery is rarely required, unless ischemic colitis is a complication of a vascular procedure or there is full-thickness necrosis. About 5% of patients have a recurrence. Occasionally, strictures develop at the site of the ischemia several weeks later, necessitating surgical resection.

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