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Bowel Ischaemia- Ischaemic colitis (Cause (Emoli , Decreased cardiac…
Bowel Ischaemia- Ischaemic colitis
TYPES
Chronic mesenteric ischaemia
Ischaemic colitis
Acute mesenteric ischaemia
Ischameic Colitis (also called abdominal angina)
Normally caused by low flow to the inferior mesenteric artery
Epidemiology
Related to atherosclerosis and vessel occulsion
Young population cause is thrombophilia, vasculitis and Oral Contraceptive pill
Older age group usually
Cause
Emoli
Decreased cardiac output i.e. arrhythmia
Thrombosis
Drugs- Oral contracpetive pill
Vasculitis SLE, sickle cells disease and polyarthritis nodosa
Risk Factors
Nicorandil drug
Thrombophilia
Contraceptove pill
Vasculitis
Pathophysiology
Most common sites of impact are the watershed areas!! The splenic flexure for example
Occlusion of the superior or inferior mesenteric artery due to atheroscleriosis or vasculitis
Clinical presentation
Passage of Red blood with or without diarrhea
Signs of shock (weak pulse rate, pale, reduced urine output and confusion)
Lower left side abdominal pain
Diagnosis
Flexible sigmoidoscopy
Colonoscopy and biopsy- gold standard
Need to do an urgent CT scan to exclude perforation
Barium enema
Treatment
Antibiotics
Surgical excision
Stoma formation
FLuid replacement
High Mortality rate