| Ischemic Colitis |
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| CATEGORIES ABOUT ISCHEMIC COLITIS | |
| gastroenterology | |
| ischemic colitis | |
AETIOLOGY Non-occlusive ischemia In hemodynamic instable patients (i.e. shock ) the mesenteric perfusion may be compromized. This condition is commonly asymptomatic, and usually only apparent through a Systemic Inflammatory Response . Mortality is roughly 70% Occlusive ischemia Mostly the result of a thromboembolism of the Arteria Mesenterica Superior or the venae mesenterica (rare). Commonly the embolism is caused by Atrial Fibrillation , valvular disease, Myocardial Infarction , or Cardiomyopathy . SIGNS AND SYMPTOMS Signs and Symptom s of ischemic colitis may be subtle but can include altered mental state, severe abdominal Pain , Fever , tachycardia, Vomiting , Bloody Diarrhea , and Septic Shock . DIAGNOSIS Computed Tomography is very useful in evaluating patients for enteric ischemia, but also in strangulation complicated closed-loop intestinal obstruction. Imaging is more reliable when used as transmural necrosis has developed. Should the findings remain non-specific one could perform Angiography which is considered the best tool for diagnosing mesenteric ischemia. When colonic ischemia is suspected Endoscopic evaluation is the preferred method. TREATMENT Non-occlusive ischemia is treated by maintaining Blood Pressure to ensure adequate perfusion and oxygenation of the gut. Acute occlusive ischemia requires urgent surgery. REFERENCE EXTERNAL LINK |
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