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Colitis, Ischemic

Praphopphat Adhatamsoontra, MD, MPH, Nicole A. Doria, MD and Marie L. Borum, MD, EdD, MPH Reviewed 06/2018
 


BASICS

Ischemic colitis (IC) results from decreased blood flow to the colon with resultant inflammation and tissue damage. 

DESCRIPTION

  • More common in the elderly; can affect patients of all ages

  • Patient...

DIAGNOSIS

  • Diagnosis is based on history, risk factors, and physical examination (2)[A].

  • Laboratory values and radiographic findings are usually nonspecific (2)[A].

  • Colonoscopy is diagnostic (2)[A].

HISTORY

TREATMENT

  • Treatment depends on disease severity (2)[A].

  • Continuous clinical monitoring, including vital signs and serial abdominal exams (6)[A]

  • In the absence of colonic necrosis or perforation, most pa...

ONGOING CARE

DIET

  • Bowel rest until symptoms resolve

  • Parenteral nutrition for patients needing prolonged bowel rest who have contraindications to surgery

PROGNOSIS

  • In most patients, IC symptoms resolve in ...

REFERENCES

1
1 Brandt LJ, Feuerstadt P, Longstreth GF, et al. ACG clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon ischemia (CI). Am J Gastro...

ADDITIONAL READING

  • Cosse C, Sabbagh C, Browet F, et al. Serum value of procalcitonin as a marker of intestinal damages: type, extension, and prognosis. Surg Endosc.  2015;29(11):3132–3139. {L-End...

CODES

ICD10

  • K55.9 Vascular disorder of intestine, unspecified

  • K55.0 Acute vascular disorders of intestine

  • K55.1 Chronic vascular disorders of intestine

ICD9

  • 557.9 Unspecified vascular insufficiency of inte...

CLINICAL PEARLS

  • Suspect IC in patients with multiple risk factors who present with abdominal pain and loose bloody stools.

  • Colonoscopy is the diagnostic gold standard.

  • Most often, IC is self-limited, re...

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