Abstract
Ischemic colitis is a commonly misunderstood clinical condition. Although the colon
is the most common region of ischemia in the gastrointestinal tract, many surgeons
have difficulty with diagnosis and treatment of ischemic colitis. The process can
occur from either occlusive vascular disease or nonocclusive disease, and can be gangrenous
or nongangrenous. Differentiating gangrenous from nongangrenous disease can be a difficult
clinical challenge as both sets of patients generally present with abdominal pain
and bloody diarrhea. Although the majority of patients have transient ischemia with
nongangrenous colitis that can be successfully managed nonoperatively, prompt recognition
and surgical intervention is critical in patients with gangrenous colitis. In this
article, the diagnosis and treatment of ischemic colitis is reviewed with emphasis
on a systematic, evidence-based approach to management.
Keywords
ischemic colitis - gastrointestinal bleeding - colonoscopy - colectomy
