ischemic colitis

(redirected from Ischemic bowel)

colitis

 [ko-li´tis]
inflammation of the colon. There are many types of colitis, each with different etiologies; the differential diagnosis involves the clinical history, stool examinations, sigmoidoscopy, and radiologic studies such as a lower gastrointestinal series. One of the most common types is idiopathic ulcerative colitis, which is characterized by extensive ulcerations along the mucosa and submucosa of the bowel. Other types often can be traced to such etiologic factors as bacteria and viruses, drugs such as antibiotics, and radiation from x-rays or radioactive materials. Strong emotions can cause hypermotility of the gut and thereby produce symptoms typical of colitis. True colitis should be distinguished from irritable bowel syndrome (formerly referred to by other names such as mucous colitis, irritable colon, and spastic colon); in the latter condition there is no actual inflammation of the gastrointestinal mucosa. Almost all forms of colitis cause lower abdominal pain, bleeding from the bowel, and diarrhea. The patient may have as many as 20 bowel movements a day, resulting in serious depletion of body fluids and electrolytes. Treatment is aimed at eliminating or mitigating the underlying cause of the inflammatory process, resting and soothing the inflamed bowel, and restoring the nutritional status and fluid and electrolyte balance to normal.
antibiotic-associated colitis colitis associated with antimicrobial therapy, most commonly with lincomycin or clindamycin, but also with other broad-spectrum antibiotics, such as ampicillin and tetracycline. It can range from mild nonspecific colitis and diarrhea to severe fulminant pseudomembranous colitis with profuse watery diarrhea, abdominal cramps, and fever. The inflammation may be caused by a toxin produced by Clostridium difficile, a microorganism that is normally present in the resident bowel flora of infants, but is rarely found in adults. Presumably, the disruption of the normal flora allows the growth of C. difficile.
collagenous colitis a type of colitis of unknown etiology characterized by deposits of collagenous material beneath the epithelium of the colon, with crampy abdominal pain and watery diarrhea.
Crohn's colitis Crohn's disease.
diversion colitis inflammation in a nonfunctioning colonic pouch created by corrective surgery; it resolves following restoration of intestinal continuity.
ischemic colitis acute vascular insufficiency of the colon, usually involving the portion supplied by the inferior mesenteric artery; symptoms include pain at the left iliac fossa, bloody diarrhea, low-grade fever, abdominal distention, and abdominal tenderness. The classic radiologic sign is thumbprinting, due to localized elevation of the mucosa by submucosal hemorrhage or edema. Ulceration may follow.
pseudomembranous colitis a severe acute inflammation of the bowel mucosa, with the formation of pseudomembranous plaques; it is usually associated with antimicrobial therapy (antibiotic-associated colitis). The common symptoms are watery diarrhea, abdominal cramps, and fever. The pathologic lesions are yellow-green pseudomembranous plaques of mucinous inflammatory exudate distributed in patches over the colonic mucosa and sometimes also in the small intestine. Called also pseudomembranous enterocolitis.
radiation colitis colitis resulting from radiation therapy to the abdominal region; it is manifested clinically by tenesmus, pain, rectal bleeding, diarrhea, and telangiectases. Malabsorption, ulceration, and partial or complete obstruction may follow.
ulcerative colitis see ulcerative colitis.

ischemic colitis

GI disease A condition characterized by intermittent abdominal colic, accompanied by nausea, tenesmus, fever, bloody diarrhea, due to ASHD of the mesenteric arteries which primarily impacts on the descending colon Prognosis Relatively good, due to the high rate of turnover of glandular epithelium. See Intestinal angina.
References in periodicals archive ?
Features of low-flow vascular states such as sepsis, congestive heart failure, use of ionotropic agents, and other causes of hypotension in the acute setting should lead to a high index of suspicion for ischemic bowel and a low threshold for surgery.
The standard therapy is anticoagulant (unfractionated heparin or low-molecular-weight heparins) administration, but there is still low possibility to need surgery for the complications such as bowel stricture or ischemic bowel disease.
Furthermore, due to the very good regeneration ability of the bowel mucosa even badly looking ischemic bowel may improve after establishment of vascularity.
Surgery for lower GI bleeding is usually reserved for patients with uncontrollable bleeding and failed angiographic embolization, or postembolization ischemic bowel complications (6, 15).
Because the patient often had intermittent abdominal pain and bloody stools, this disease should be made differential diagnosis from Crohn's disease, ulcerative colitis, colorectal cancer, diverticulitis, ischemic bowel disease and amyloidosis, etc.
Ischemia of intraperitoneal organs with obstruction feature are identified in these reports specifically with eosinophilic gastroenteritis (EGE) and ischemic bowel disease/mesenteric ischemia (MI) [3-5].
The patient also underwent an explorative laparotomy as a part of a staged procedure to address the ischemic bowel caused by the presumed septic emboli.
Later that day patient started complaining of increased abdominal pain concerning for bowel perforation; hence an immediate diagnostic laparoscopy was done which showed edematous bowel but no other significant abnormalities and ruled out ischemic bowel. Ascitic fluid gram stain was negative; ascitic fluid and peritoneal cultures were sent.
Surgical treatment can be either caecostomy or, in case of ischemic bowel, hemicolectomy with or without primary anastomosis or total abdominal colectomy.
Unfortunately, it is difficult to accurately diagnose ischemic bowel on CAT scan [4].
Since our primary goal was to investigate the association between preoperative serum lactate and the extent of bowel ischemia, the study population was divided into subgroups depending on the length of the ischemic bowel segment using 50 cm as cut-off: [less than or equal to] 50 cm, 51-100 cm, >100 cm, and multivisceral.
(21) There should be a high index of suspicion for an internal hernia in any post-gastric bypass patient presenting with abdominal pain due to the potential for ischemic bowel, which is associated with high morbidity and mortality.