Ischemic colitis causes: Difference between revisions

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{{Ischemic colitis}}
{{Ischemic colitis}}
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==Overview==
==Overview==
Causes of the reduced blood flow can include changes in the systemic circulation (e.g. [[hypotension|low blood pressure]]) or local factors such as [[vasoconstriction|constriction of blood vessels]] or a [[blood clot]]. In most cases, no specific cause can be identified.<ref>Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 7th ed., 2002 Saunders, p. 2332.</ref>
Causes of reduced blood flow leading to ischemic colitis include changes in the systemic circulation such as [[hypotension|low blood pressure]] (hypotension) or local factors such as [[vasoconstriction|constriction of blood vessels]], a [[blood clot]], or drugs. In most cases, no specific cause can be identified.


==Causes==
==Causes==
Ischemic colitis is often classified according to the underlying cause. Non-occlusive ischemia develops because of [[low blood pressure]] or constriction of the vessels supplying blood to the colon; occlusive ischemia indicates that a [[blood clot]] or other blockage has cut off blood flow to the [[colon]]. In most cases, no specific cause can be identified.
The causes of ischemic colitis are as follows:<ref name="HassKozuch2007">{{cite journal|last1=Hass|first1=David J.|last2=Kozuch|first2=Patricia|last3=Brandt|first3=Lawrence J.|title=Pharmacologically Mediated Colon Ischemia|journal=The American Journal of Gastroenterology|volume=102|issue=8|year=2007|pages=1765–1780|issn=0002-9270|doi=10.1111/j.1572-0241.2007.01260.x}}</ref><ref name="TheodoropoulouΚoutroubakis2008">{{cite journal|last1=Theodoropoulou|first1=Αngeliki|last2=Κoutroubakis|first2=Ioannis E|title=Ischemic colitis: Clinical practice in diagnosis and treatment|journal=World Journal of Gastroenterology|volume=14|issue=48|year=2008|pages=7302|issn=1007-9327|doi=10.3748/wjg.14.7302}}</ref><ref>Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 7th ed., 2002 Saunders, p. 2332.</ref>
 
*Ischemic colitis is often classified according to the underlying cause.  
**Non-occlusive [[ischemia]] develops because of [[low blood pressure]] or constriction of the [[Blood vessel|vessels]] supplying [[blood]] to the [[Colon (anatomy)|colon]].
**[[Thromboembolism|Occlusive]] [[ischemia]] indicates that a [[blood clot]] or other blockage has cut off [[blood]] flow to the [[colon]].  


===Non-occlusive Ischemia===
===Non-occlusive Ischemia===
In hemodynamically unstable patients (i.e. [[shock]] patients) the [[mesenteric]] perfusion may be compromised.
* In [[Hemodynamics|hemodynamically]] unstable patients the [[mesenteric]] perfusion can be compromised.


===Occlusive Ischemia===
===Occlusive Ischemia===
Occlusive ischemia is due to either:
*[[Cardiovascular disease|Obstructive]] [[Atherosclerosis|atherosclerotic]] disease
**[[Superior mesenteric artery]] occlusion


1. Obstructive atherosclerotic disease
* [[Thromboembolism]]
:*[[Superior mesenteric artery]] occlusion
** Most commonly the [[embolism]] is due to [[atrial fibrillation]]
2. [[Thromboembolism]]:
** [[Valvular heart disease]] including [[endocarditis]]
:*Most commonly the embolism is due to [[atrial fibrillation]]
** [[Myocardial infarction]]
:*[[Valvular heart disease]] including [[endocarditis]]
** [[Cardiomyopathy]]
:*[[Myocardial infarction]]
 
:*[[Cardiomyopathy]]
*[[Hernia]]
*[[Tumor]]


===Drugs===
===Drugs===
The following drugs cause vasoconstriction which may compromise blood supply to the colon.
*[[Alosetron]]
*[[Alosetron]]
*[[Cilansetron]]
*[[Cilansetron]]
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*[[Pegylated interferon alfa-2b]]
*[[Pegylated interferon alfa-2b]]
*[[Ramosetron]]
*[[Ramosetron]]
*[[Vasopressors]]
*[[Ergotamine]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 14:16, 5 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]

Overview

Causes of reduced blood flow leading to ischemic colitis include changes in the systemic circulation such as low blood pressure (hypotension) or local factors such as constriction of blood vessels, a blood clot, or drugs. In most cases, no specific cause can be identified.

Causes

The causes of ischemic colitis are as follows:[1][2][3]

Non-occlusive Ischemia

Occlusive Ischemia

Drugs

The following drugs cause vasoconstriction which may compromise blood supply to the colon.

References

  1. Hass, David J.; Kozuch, Patricia; Brandt, Lawrence J. (2007). "Pharmacologically Mediated Colon Ischemia". The American Journal of Gastroenterology. 102 (8): 1765–1780. doi:10.1111/j.1572-0241.2007.01260.x. ISSN 0002-9270.
  2. Theodoropoulou, Αngeliki; Κoutroubakis, Ioannis E (2008). "Ischemic colitis: Clinical practice in diagnosis and treatment". World Journal of Gastroenterology. 14 (48): 7302. doi:10.3748/wjg.14.7302. ISSN 1007-9327.
  3. Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 7th ed., 2002 Saunders, p. 2332.

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