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Ischemic Colitis

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General Surgery

Pearls and Pitfalls

  • The etiology of ischemic colitis is usually related to a low flow state.

  • The symptoms of ischemic colitis are usually non-specific.

  • One of the key points in diagnosis is a high index of suspicion by the clinician, especially in patients with risk factors.

  • Currently, there are no sensitive or specific laboratory tests for detection of early ischemic colitis.

  • Colonoscopy within the first 3 days of symptoms is the best diagnostic method for ischemic colitis.

  • For patients without evidence of transmural ischemia, an initial trial of conservative management may be employed; conservative non-operative treatment is successful in the majority of patients with ischemic colitis (non-transmural ischemia).

  • Careful observation with repeated evaluation is necessary in patients managed conservatively to assure absence of progressive disease.

  • Only 15–20% of the patients require emergency operation, with mortality rates of 50–60% (transmural ischemia).

  • Segmental resection of the...

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Selected Readings

  • Brandt LJ (2000) AGA technical review on intestinal ischemia. Gastroenterology 118:954–968

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  • Church J (1995) Ischemic colitis. In: Church J (ed) Endoscopy of the colon, rectum and anus. Igaku-Shoin, New York/Tokyo, 328–331

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  • Higgins PDR, Davis KJ, Laine L (2004) Systematic review: the epidemiology of ischemic colitis. Aliment Pharmacol Ther 19:729–738

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  • MacDonald PH (2002) Ischemic colitis. Best Pract Res Clin Gastroenterol 16:51–61

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  • Medina C, Vilaseca J, Videla S, et al. (2004) Outcome of patients with ischemic colitis: review of fifty-three cases. Dis Colon Rectum 47:180–184

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  • Sreenarasimhaiah J (2005) Diagnosis and management of ischemic colitis. Current Gastroenterology Reports 7:421–426

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Authors and Affiliations

    Authors
    1. Mario A. Abedrapo Moreira
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    2. Gonzalo Soto Debeuf
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    Editor information

    Editors and Affiliations

    1. Department of Surgery, Deputy Director, Comprehensive Cancer Center University of Alabama School of Medicine, Birmingham, AL, USA

      Kirby I. Bland MD (Fay Fletcher Kerner Professor and Chairman) (Fay Fletcher Kerner Professor and Chairman)

    2. Department of General and Visceral Surgery, University of Heidelberg, Heidelberg, Germany

      Markus W. Büchler MD (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

    3. Department of Surgery, University Hospital, Santiago, Chile

      Attila Csendes MD, FACS (Hon) (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

    4. James C. Mason Professor of Surgery Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

      Michael G. Sarr MD

    5. Department of Clinical and Surgical Sciences, The University of Edinburgh Royal Infirmary of Edinburgh, Edinburgh, UK

      O. James Garden MBChB, MD, FRCS (Ed), FRCP (Ed), FRACS (Hon) (Regius Professor of Clinical Surgery) (Regius Professor of Clinical Surgery)

    6. Department of Surgery, The University of Hong Kong Queen Mary Hospital, Hong Kong, China

      John Wong BSc (Med (Syd)), MBBS (Syd), PhD (Syd), MD (Hon (Syd)), FRACS, FRCS (Edin), FRCS (Glasg), FACS (Hon) (Chair Professor) (Chair Professor)

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    © 2009 Springer Science+Business Media, LLC

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    Moreira, M.A.A., Debeuf, G.S. (2009). Ischemic Colitis. In: Bland, K.I., Büchler, M.W., Csendes, A., Sarr, M.G., Garden, O.J., Wong, J. (eds) General Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-833-3_84

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    • DOI: https://doi.org/10.1007/978-1-84628-833-3_84

    • Publisher Name: Springer, London

    • Print ISBN: 978-1-84628-832-6

    • Online ISBN: 978-1-84628-833-3

    • eBook Packages: MedicineReference Module Medicine

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