Ischemic colitis history and symptoms
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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
Ischemic colitis is characterized by abdominal pain which is out of proportion to physical findings, specifically excruciating abdominal pain despite limited focal tenderness.
History and Symptoms
The history and symptoms of ischemic colitis are as follows:[1][2][3][4][5]
- Sudden onset of crampy abdominal pain, diarrhea and an urge to defecate.
- The pain is mild, located over the affected bowel, usually to the left side of the lower abdomen.
- Mild rectal bleeding within 24 h.
- The blood may be bright red or maroon mixed with the stools.
- Rectal bleeding is minimal.
- Hematochezia with hemodynamic instability suggests a different diagnosis.
- Associated ileus may be manifested by anorexia, nausea and vomiting.
Signs
- Clinical examination of the abdomen reveals mild to moderate tenderness over the affected area of the colon.
- Rectal examination shows heme-positive stools.
- In cases of severe ischemia with transmural infarction and necrosis, marked tenderness with peritoneal signs may be present on physical examination accompanied by metabolic acidosis and septic shock.
Common Symptoms
- Symptoms of ischemic colitis vary depending on the severity of the ischemia.
- The most common early signs of ischemic colitis include abdominal pain (often left-sided), with mild to moderate amounts of rectal bleeding.
- The sensitivity of findings among 73 patients were as follows:
- Abdominal pain: 78% of patients
- Lower digestive bleeding: 62% of patients
- Diarrhea: 38% of patients
- Fever: Higher than 100.4°F (38°C) in 34% of patients
References
- ↑ 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.
- ↑ Boley SJ, Brandt LJ, Veith FJ (1978). "Ischemic disorders of the intestines". Curr Probl Surg. 15 (4): 1–85. doi:10.1016/S0011-3840(78)80018-5. PMID 365467. Unknown parameter
|month=ignored (help) - ↑ Hunter G, Guernsey J (1988). "Mesenteric ischemia". Med Clin North Am. 72 (5): 1091–115. PMID 3045452.
- ↑ Greenwald D, Brandt L, Reinus J (2001). "Ischemic bowel disease in the elderly". Gastroenterol Clin North Am. 30 (2): 445–73. doi:10.1016/S0889-8553(05)70190-4. PMID 11432300.
- ↑ Huguier M, Barrier A, Boelle PY, Houry S, Lacaine F (2006). "Ischemic colitis". Am. J. Surg. 192 (5): 679–84. doi:10.1016/j.amjsurg.2005.09.018. PMID 17071206.