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 advocated by most studies, and there is no evidence that its use in assessment of ischaemic colitis is unsafe when performed by experienced practitioners.4 22 Retrospective studies of a total of 659 cases reported no cases of perforation secondary to colonoscopy,23 24 in data published in recent guidance.
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.