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Ischemic Colitis
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Compromise of mesenteric blood supply leading to colonic injury

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Wongtrakul W et al: The correlation between heart failure and the risk of ischemic colitis: a systematic review and meta-analysis. Ann Gastroenterol. 34(3):378-84, 2021
                                              2. Henes FO et al: CT angiography in the setting of suspected acute mesenteric ischemia: prevalence of ischemic and alternative diagnoses. Abdom Radiol (NY). 42(4):1152-61, 2017
                                              3. Misiakos EP et al: Advents in the diagnosis and management of ischemic colitis. Front Surg. 4:47, 2017
                                              4. Chen YC et al: Comparison of ischemic and nonischemic bowel segments in patients with mesenteric ischemia: multidetector row computed tomography findings and measurement of bowel wall attenuation changes. Mayo Clin Proc. 91(3):316-28, 2016
                                              5. Hagspiel KD et al: Computed tomography angiography and magnetic resonance angiography imaging of the mesenteric vasculature. Tech Vasc Interv Radiol. 18(1):2-13, 2015
                                              6. Shetty AS et al: Limited utility of MRA for acute bowel ischemia after portal venous phase CT. Abdom Imaging. 40(8):3020-8, 2015
                                              7. Sise MJ: Acute mesenteric ischemia. Surg Clin North Am. 94(1):165-81, 2014
                                              8. Raman SP et al: MDCT and CT angiography evaluation of rectal bleeding: the role of volume visualization. AJR Am J Roentgenol. 201(3):589-97, 2013
                                              9. Tadros M et al: A review of ischemic colitis: is our clinical recognition and management adequate? Expert Rev Gastroenterol Hepatol. 7(7):605-13, 2013
                                              10. O'Neill S et al: Systematic review of the management of ischaemic colitis. Colorectal Dis. 14(11):e751-63, 2012
                                              11. Green BT et al: Ischemic colitis: a clinical review. South Med J. 98(2):217-22, 2005
                                              12. Korotinski S et al: Chronic ischaemic bowel diseases in the aged--go with the flow. Age Ageing. 34(1):10-6, 2005
                                              13. Ripolles T et al: Sonographic findings in ischemic colitis in 58 patients. AJR Am J Roentgenol. 184(3):777-85, 2005
                                              14. Sreenarasimhaiah J: Diagnosis and management of ischemic colitis. Curr Gastroenterol Rep. 7(5):421-6, 2005
                                              15. Wiesner W et al: CT of acute bowel ischemia. Radiology. 226(3):635-50, 2003
                                              16. Horton KM et al: Volume-rendered 3D CT of the mesenteric vasculature: normal anatomy, anatomic variants, and pathologic conditions. Radiographics. 22(1):161-72, 2002
                                              17. Horton KM et al: Multi-detector row CT of mesenteric ischemia: can it be done? Radiographics. 21(6):1463-73, 2001
                                              18. Horton KM et al: CT evaluation of the colon: inflammatory disease. Radiographics. 20(2):399-418, 2000
                                              19. Balthazar EJ et al: Ischemic colitis: CT evaluation of 54 cases. Radiology. 211(2):381-8, 1999
                                              20. Iida M et al: Ischemic colitis: serial changes in double-contrast barium enema examination. Radiology. 159(2):337-41, 1986
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Definitions

                                                          • Compromise of mesenteric blood supply leading to colonic injury

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • Fluoroscopic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Ultrasonographic Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Wongtrakul W et al: The correlation between heart failure and the risk of ischemic colitis: a systematic review and meta-analysis. Ann Gastroenterol. 34(3):378-84, 2021
                                                                                          2. Henes FO et al: CT angiography in the setting of suspected acute mesenteric ischemia: prevalence of ischemic and alternative diagnoses. Abdom Radiol (NY). 42(4):1152-61, 2017
                                                                                          3. Misiakos EP et al: Advents in the diagnosis and management of ischemic colitis. Front Surg. 4:47, 2017
                                                                                          4. Chen YC et al: Comparison of ischemic and nonischemic bowel segments in patients with mesenteric ischemia: multidetector row computed tomography findings and measurement of bowel wall attenuation changes. Mayo Clin Proc. 91(3):316-28, 2016
                                                                                          5. Hagspiel KD et al: Computed tomography angiography and magnetic resonance angiography imaging of the mesenteric vasculature. Tech Vasc Interv Radiol. 18(1):2-13, 2015
                                                                                          6. Shetty AS et al: Limited utility of MRA for acute bowel ischemia after portal venous phase CT. Abdom Imaging. 40(8):3020-8, 2015
                                                                                          7. Sise MJ: Acute mesenteric ischemia. Surg Clin North Am. 94(1):165-81, 2014
                                                                                          8. Raman SP et al: MDCT and CT angiography evaluation of rectal bleeding: the role of volume visualization. AJR Am J Roentgenol. 201(3):589-97, 2013
                                                                                          9. Tadros M et al: A review of ischemic colitis: is our clinical recognition and management adequate? Expert Rev Gastroenterol Hepatol. 7(7):605-13, 2013
                                                                                          10. O'Neill S et al: Systematic review of the management of ischaemic colitis. Colorectal Dis. 14(11):e751-63, 2012
                                                                                          11. Green BT et al: Ischemic colitis: a clinical review. South Med J. 98(2):217-22, 2005
                                                                                          12. Korotinski S et al: Chronic ischaemic bowel diseases in the aged--go with the flow. Age Ageing. 34(1):10-6, 2005
                                                                                          13. Ripolles T et al: Sonographic findings in ischemic colitis in 58 patients. AJR Am J Roentgenol. 184(3):777-85, 2005
                                                                                          14. Sreenarasimhaiah J: Diagnosis and management of ischemic colitis. Curr Gastroenterol Rep. 7(5):421-6, 2005
                                                                                          15. Wiesner W et al: CT of acute bowel ischemia. Radiology. 226(3):635-50, 2003
                                                                                          16. Horton KM et al: Volume-rendered 3D CT of the mesenteric vasculature: normal anatomy, anatomic variants, and pathologic conditions. Radiographics. 22(1):161-72, 2002
                                                                                          17. Horton KM et al: Multi-detector row CT of mesenteric ischemia: can it be done? Radiographics. 21(6):1463-73, 2001
                                                                                          18. Horton KM et al: CT evaluation of the colon: inflammatory disease. Radiographics. 20(2):399-418, 2000
                                                                                          19. Balthazar EJ et al: Ischemic colitis: CT evaluation of 54 cases. Radiology. 211(2):381-8, 1999
                                                                                          20. Iida M et al: Ischemic colitis: serial changes in double-contrast barium enema examination. Radiology. 159(2):337-41, 1986