bowel ischemia Flashcards
define ischemic colitis
Lack of blood supply to the colon causes inflammation and injury
what is the pathophysiology behind ischaemic colitis
1 Occlusion of a branch of SMA or IM A
2 Results in a watershed area of the colon esp at splenic flexure and sigmoid colon + rectum
3 Lack of blood flow causes pain + bleeding
what are the complications associated with ischemic colitis?
-Perforation -> Spontaneous bacterial peritonitis
-Strictures -> obstruction
what are the causes of ischemic colitis?
- thrombosis
- emboli
- atherosclerosis
- decrease CO + arrhythmias
epidemiology of ischemic colitis
elderly
what are the symptoms of ischemic colitis?
· LLQ pain
· Bright, bloody stool
· + /- signs of hypovolemic shock
how do you diagnose ischemic colitis?
Colonoscopy + biopsy (after recovered)
· Stool sample
how is ischemic colitis treated?
symptomatic
↳> IV fluid + antibiotics
· Gangrenous (infarcted Colon)
↳> only surgery
define mesenteric ischaemia
Decreased or blocked blood flow to large or small intestine
what are the two types of mesenteric ischaemia?
-Acute MI -> acute attack (abdominal MI)
- Chronic MI- longer lasting ( abdo angina)
what are the causes behind mesenteric ischaemia?
Affecting SMA:
-thrombosis
- emboli
what are the symptoms of mesenteric ischemia?
- central/ IRF acute severe abdo pain
- no abdo signs on exam ( e.g guarding/ rebound tender)
- rapid hypovolemic shock
how is mesenteric ischaemia diagnosed?
- CT angiogram
- shows arterial blockage - FBC + ABG
- persistent metabolic acidosis
how is mesenteric ischaemia treated?
- fluid resuscitation
- antibiotics
- iv heparin
- infected bowel- surgery
what are the two types of bowel ischaemia?
- ischemic colitis
- mesenteric ischaemia
