Gastroenterology
Ischemic Colitis & Acute Mesenteric Ischemia
Gastroenterology

Ischemic Colitis & Acute Mesenteric Ischemia

Watershed vs embolic.

Select any text to highlight it or make a flashcard.

◆Ischemic colitis (watershed)

  • •Recent hypotension or AAA repair + LLQ crampy pain + hematochezia
  • •Watershed areas: splenic flexure (SMA/IMA) and rectosigmoid (IMA/hypogastric)
  • •CT: bowel wall thickening, thumbprinting
  • •Colonoscopy: pale, edematous, friable mucosa ± ulceration
  • •Supportive care + bowel rest + IV fluids; abx if moderate-severe

◆Acute mesenteric ischemia (SMA embolus)

  • •AFib + severe abd pain out of proportion to exam + metabolic acidosis
  • •CT angiography immediately
  • •Emergent surgical embolectomy ± resection of necrotic bowel
Done reading?
Track your progress by marking this complete.
Next in Gastroenterology