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Encyclopedia > Ischemic colitis

Ischemic colitis is inflammation of the intestine (colitis) caused by inadequate blood supply (ischemia) to meet the metabolic demands.[1] Colitis is a digestive disease characterized by inflammation of the colon. ... In medicine, ischemia (Greek ισχαιμία, isch- is restriction, hema or haema is blood) is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. ...

Contents


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%[1] In medicine, systemic inflammatory response syndrome (SIRS) is an inflammatory state of the whole body (the system). It is characterized by fast heart rate (tachycardia, heart rate >90/min), low blood pressure (systolic <90 or MAP <65), low or high body temperature (<36 or >38 C), high respiratory rate (>20...


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.[1] The superior mesenteric artery arises from the anterior surface of the aorta, just inferior to the origin of the celiac trunk, and supplies the intestine from the duodenum and pancreas to the left colic flexure. ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ... A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, totally occluding the artery and preventing blood flow downstream. ...


Signs and symptoms

Signs and symptoms of ischemic colitis may be subtle but can include altered mental state, severe abdominal pain, fever, tachycardia, vomiting, bloody diarrhea, and septic shock. In medicine, a sign is a feature of disease as detected by the doctor. ... The term symptom (from the Greek syn = con/plus and pipto = fall, together meaning co-exist) has two similar meanings in the context of physical and mental health: A symptom may loosely be said to be a physical condition which shows that one has a particular illness or disorder (see... Pain is an unpleasant sensation which may be associated with actual or potential tissue damage and which may have physical and emotional components. ... See Fever for the Kylie Minogue album; Fever is also a song by Otis Blackwell. ... Vomiting (or emesis) is the forceful expulsion of the contents of ones stomach through the mouth. ... In medicine, when refering to human feces, Blood in stool can refer to several distinct conditions: Melena Fecal occult blood Hematochezia In infants, the Apt test can be used to distinguish Fetal hemoglobin from maternal blood. ... Diarrhea (American English) or diarrhoea (Commonwealth English) is a condition in which the sufferer has frequent and watery, chunky, or loose bowel movements (from the ancient Greek word διαρροή = leakage; lit. ... Septic shock is a serious medical condition causing such effects as multiple organ failure and death in response to infection and sepsis. ...


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.[1] CT apparatus in a hospital Computed tomography (CT), originally known as computed axial tomography (CAT) and body section roentgenography, is a medical imaging method employing tomography where digital geometry processing is used to generate a three-dimensional image of the internals of an object from a large series of two... Angiography or arteriography is a medical imaging technique in which an X-ray picture is taken to visualize the inner opening of blood filled structures, including arteries, veins and the heart chambers. ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a fiber optic camera on a flexible tube passed through the anus. ...


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.[1] Blood pressure is the pressure exerted by the blood on the walls of the blood vessels. ...


Reference

  1. a b c d e Textbook
    • Intensive Care Medicine by Irwin and Rippe
    • The ICU Book by Marino

    External link

    • - MedlinePlus Medical Encyclopedia

     
     

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