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Ischemic Colitis

  • Etienne Danse
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Ischemic colitis is the most usual form of acute intestinal ischemia. It includes mainly two forms: the transient form with spontaneous resolution and the severe form. Two types of severe forms of ischemic colitis are to be considered: (a) ischemic colitis associated with a delayed stenosis caused by colic wall fibrosis, (b) ischemic colitis complicated by an early perforation caused by gangrenous evolution. Its diagnosis is based on the association of clinical data, endoscopic findings, radiological data and histology. Sonography can detect colic wall changes in cases of ischemic colitis such as increased colic wall thickening (8–9 mm), disappearance of the wall stratification (not systematic but more frequently noted than in other acute colic diseases), absence or reduced mural flow with color Doppler (in 20–50 % of patients with final diagnosis of ischemic colitis). Sonography can also detect hyperechogenicity of the pericolic fatty tissue and may be useful to delimitate the disease extension along the colic wall and its localization.

Keywords

Inferior Mesenteric Artery Celiac Trunk Ischemic Colitis Severity Factor Transient Form 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Balthazar EJ, Yen BC, Gordon RB (1999) Ischemic colitis: CT evaluation of 54 cases. Radiology 211:381–388PubMedGoogle Scholar
  2. Boley JS (1990) Colonic ischemia-25 years later. Am J Gastroenterol 85:931–934PubMedGoogle Scholar
  3. Bowersox JC, Zwolak RM, Walsh DB et al (1991) Duplex ultrasonography in the diagnosis of celiac and mesenteric artery occlusive disease. J Vasc Surg 14:780–788PubMedCrossRefGoogle Scholar
  4. Bozkurt T, Richter F, Lux G (1994) Ultrasonography as a primary diagnostic tool in patients with inflammatory disease and tumors of the small intestine and the large bowel. J Clin Ultrasound 22:85–91PubMedCrossRefGoogle Scholar
  5. Cheung AH, Wang KY, Jiranek GC et al (1992) Evaluation of a 20 MHz ultrasound transducer used in diagnosing porcine small bowel ischemia. Invest Radiol 27:217–223PubMedCrossRefGoogle Scholar
  6. Chou CK (2002) CT manifestations of bowel ischemia. AJR Am J Roentgenol 178:87–91PubMedCrossRefGoogle Scholar
  7. Danse E (2004) Imagerie des urgences abdominales non traumatiques de l’adulte. Encyclopédie Médico-Chirurgicale 33:705Google Scholar
  8. Danse EM, Laterre PF, Van Beers BE et al (1997) Early diagnosis of acute intestinal ischemia: contribution of color Doppler sonography. Acta Chir Belg 97:173–176PubMedGoogle Scholar
  9. Danse EM, Van Beers BE, Jamart J et al (2000a) Prognosis of ischemic colitis: comparison of color Doppler sonography with early clinical and laboratory findings. AJR Am J Roentgenol 175:1151–1154PubMedCrossRefGoogle Scholar
  10. Danse EM, Van Beers BE, Materne R (2000b) Small bowel wall changes in acute mesenteric ischemia: sonographic findings. Ultrasound Med Biol 26:A128CrossRefGoogle Scholar
  11. Danse EM, Hammer F, Matondo H et al (2001) Ischémie mésentérique chronique d’origine artérielle: mise en évidence de réseaux de vicariance par échographie Doppler couleur. J Radiol 82:1645–1649PubMedGoogle Scholar
  12. Danse E, Jamart J, Hoang P et al (2004) Focal bowel wall changes detected with colour Doppler ultrasound: diagnostic value in acute non-diverticular diseases of the colon. Br J Radiol 77:917–921PubMedCrossRefGoogle Scholar
  13. Danse E, Dewit O, Goncette L et al (2005) Que faire en cas d’affection aiguë du colon? Une échographie, un scanner, des clichés conventionnels ou une endoscopie? SFR Paris octobre 2005. Formation Médicale Continue 23:241–253Google Scholar
  14. Federle MP, Chun G, Jeffrey RB, Rayor R (1984) Computed tomographic findings in bowel infarction. AJR Am J Roentgenol 142:91–95PubMedCrossRefGoogle Scholar
  15. Hata J, Haruma K, Suenaga K et al (1992) Ultrasonographic assessment of inflammatory bowel disease. Am J Gastroenterol 87:443–447PubMedGoogle Scholar
  16. Horton KM, Corl FM, Fishman EK (2000) CT evaluation of the colon: inflammatory disease. Radiographics 20:399–418PubMedGoogle Scholar
  17. Jeffrey RB, Sommer G, Debatin JF (1994) Color Doppler sonography of focal gastrointestinal lesions: initial clinical experience. J Ultrasound Med 13:473–478PubMedGoogle Scholar
  18. Longo WE, Ballantyne GH, Gusberg RJ (1992) Ischemic colitis: patterns and prognosis. Dis Colon Rectum 35:726–730PubMedCrossRefGoogle Scholar
  19. Longo WE, Ward D, Vernava AM, Kaminski DL (1997) Outcome of patients with total colonic ischemia. Dis Colon Rectum 40:1448–1454PubMedCrossRefGoogle Scholar
  20. Marston A, Pheils MT, Thomas ML, Morson BC (1966) Ischaemic colitis. Gut 7:1–15PubMedCrossRefGoogle Scholar
  21. Philpotts LE, Heiken JP, Westcott MA, Gore RM (1994) Colitis: use of CT findings in differential diagnosis. Radiology 190:445–449PubMedGoogle Scholar
  22. Quillin SP, Siegel MJ (1994) Gastrointestinal inflammation in children: color Doppler ultrasonography. J Ultrasound Med 13:751–756PubMedGoogle Scholar
  23. Ranschaert E, Verhille R, Marchal G, Rigauts H, Ponette E (1994) Sonographic diagnosis of ischemic colitis. J Belge Radiol 77:166–168PubMedGoogle Scholar
  24. Ripolles T, Simo L, Martinez-Perez MJ et al (2005) Sonographic findings in ischemic colitis in 58 patients. AJR Am J Roentgenol 184:777–785PubMedCrossRefGoogle Scholar
  25. Robert JH, Mentha G, Rohner A (1993) Ischaemic colitis: two distinct patterns of severity. Gut 34:4–6PubMedCrossRefGoogle Scholar
  26. Shirahama M, Ishibashi H, Onohara S, Dohmen K, Miyamoto Y (1999) Color Doppler ultrasound for the evaluation of bowel wall thickening. Br J Radiol 72:1164–1169PubMedGoogle Scholar
  27. Siegel MJ, Friedland JA, Hildebolt CF (1997) Bowel wall thickening in children: differentiation with US. Radiology 203:631–635PubMedGoogle Scholar
  28. Teefey SA, Roarke MC, Brink JA et al (1996) Bowel wall thickening; differentiation of inflammation from ischemia with color Doppler and duplex US. Radiology 198:547–551PubMedGoogle Scholar
  29. Toursarkissian B, Thompson RW (1997) Ischemic colitis. Surg Clin North Am 77:461–470PubMedCrossRefGoogle Scholar
  30. Wiesner W, Mortelé KJ, Glickman JN, Ji H, Ros P (2001) Pneumatosis intestinal and portomesenteric venous gas in intestinal ischemia: correlation of CT findings with severity of ischemia and clinical outcome. AJR Am J Roentgenol 177:1319–1323PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of RadiologySt-Luc University Hospital, Université Catholique de LouvainBrusselsBelgium

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