Ischemic colitis other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]
Overview
Among patients with a suspicion of ischemic colitis, endoscopic evaluation, via colonoscopy or flexible sigmoidoscopy, is the diagnostic procedure of choice if the diagnosis remains unclear after other imaging studies.
Endoscopy
- Ischemic colitis has a distinctive endoscopic appearance; endoscopy can also facilitate alternate diagnoses such as infection or inflammatory bowel disease. Biopsies can be taken via endoscopy to provide more information.[1]
- Early endoscopy can confirm the diagnosis and provides prognostic information.
- Distinguishes between cases that need conservative management versus those that require emergency resection.
- Transient non-gangrenous features of ischemic colitis observed at colonoscopy include:
- Petechial haemorrhages
- Edematous and fragile mucosa
- Segmental erythema
- Scattered erosions
- Longitudinal ulcerations (colon single stripe sign)
- A sharply defined segment of involvement
- Transmural ischemia will show:
- Cyanosis and pseudo-polyps
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Colonoscopy
- Colonoscopy is more sensitive and allows visualization of colonic mucosa and histological analysis of biopsies.
- Diagnosis requires colonoscopy within 48 hours.
- Serial studies in connection with the clinical setting are necessary to establish the diagnosis.
References
- ↑ MacDonald, P.H. (2002). "Ischaemic colitis". Best Practice & Research Clinical Gastroenterology. 16 (1): 51–61. doi:10.1053/bega.2001.0265. ISSN 1521-6918.