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Colitis, Ischemic

Marie L Borum, MD, EdD, MPH and Joseph H. Cioffi, MD Reviewed 06/2022
 


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

  • IC is s...

DIAGNOSIS

  • Diagnosis is based on history, risk factors, and physical examination (3)[A].

  • Laboratory values and radiographic findings are usually nonspecific (3)[A].

  • Colonoscopy is diagnostic (3)[A].

HISTORY

TREATMENT

  • Treatment depends on disease severity (3)[A].

  • Continuous clinical monitoring, including vital signs and serial abdominal exams (7)[A]

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

ONGOING CARE

DIET

  • Bowel rest until symptoms resolve

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

PATIENT EDUCATION

Risks of ischemic colitis with th...

REFERENCES

1
Brandt  LJ, Feuerstadt  P, Longstreth  GF, et al. ACG clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon i...

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.  ...

CODES

ICD10

  • K55.9 Vascular disorder of intestine, unspecified

  • K55.0 Acute vascular disorders of intestine

  • K55.1 Chronic vascular disorders of intestine

SNOMED

  • 30588004 Ischemic colitis (disorder)

  • 75700000 A...

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 and...

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