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Ischaemic colitis.

P H MacDonald1

  • 1Dept. Surgery, Hotel Dieu Hospital, Queen's University, Kingston, Ontario, Canada.

Best Practice & Research. Clinical Gastroenterology
|April 30, 2002
PubMed
Summary
This summary is machine-generated.

Ischaemic colitis, often affecting the elderly, involves reduced blood flow to the colon. While often self-limiting with conservative treatment, severe cases require surgery with a guarded prognosis.

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Area of Science:

  • Gastroenterology
  • Vascular Medicine

Background:

  • Colonic ischaemia, first described 40 years ago, was initially diagnosed only in cases of gangrene.
  • Reversible non-transmural ischaemia of the colon was recognized in the 1960s, with extensive research following.
  • Ischaemic colitis primarily affects the elderly, but its true incidence is unknown due to undiagnosed cases.

Purpose of the Study:

  • To discuss known facts about the pathophysiology and aetiology of colonic ischaemia.
  • To highlight the importance of clinical suspicion in diagnosing the condition.
  • To review diagnostic modalities and treatment approaches for ischaemic colitis.

Main Methods:

  • Review of existing literature on colonic ischaemia.
  • Discussion of pathophysiology and aetiology, including occlusive and non-occlusive vascular disease.

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  • Description of diagnostic tools, emphasizing colonoscopy.

    • Main Results:

    • Non-occlusive vascular disease is more common than occlusive disease in colonic ischaemia.
    • The exact pathophysiology of non-occlusive disease requires further research.
    • Most patients experience self-limiting disease and respond to conservative therapy.

    Conclusions:

    • A high degree of clinical suspicion is crucial for diagnosing colonic ischaemia.
    • Colonoscopy is the primary method for accurate diagnosis.
    • Transmural infarction necessitates surgical intervention with a guarded prognosis, especially in elderly patients with comorbidities.