Ischemic enterocolitis and its differential diagnosis

Ischemia is a common type of gastrointestinal injury that can be clinically misdiagnosed due to its often mild and transient clinical presentation as well as a tendency to masquerade as other disorders. A wide range of etiologies can contribute to the development of ischemia. These include hypovolemic states, systemic diseases such as vasculitis and hypercoagulable states, mechanical obstruction, therapeutic drug effects, infection, and a host of other diseases. An accurate diagnosis of ischemia relies on a strong clinical suspicion in combination with endoscopic and pathologic findings. Most cases show histologic features that are diagnostic of ischemia, but do not point to a specific differential diagnosis, whereas the cause of ischemia can be recognized or suspected based on careful review of vascular changes in others. This review is focused on providing an overview of ischemic enterocolitis and its differential diagnosis.