ISCHEMIC COLITIS

Question 1

Definition (4)

Answer 1

• Acute or chronic intestinal ischemia secondary to decreased intestinal perfusion or thromboembolism
• Usually affects watershed areas (splenic flexure or cecum)
• Usually in elderly with underlying atherosclerosis, esp. post-AAA repair
• May occur if young with RFs (OCP, thrombophilia, vasculitis, cocaine abuse)

Question 2

Presentation

Answer 2

Abdominal pain, rectal bleeding, +/- shock

Question 3

Findings

Answer 3

Abdominal x-ray shows pneumatosis air in bowel wall or thumbprinting (submucosal edema)

Question 4

Treatment

Answer 4

Treatment in mild cases depends on IV fluids. If moderate with fever and high WBCs —> IV antibiotics. If severe —> surgical