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Colon ischemia

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It i a chronic type of mesenteric ischemia, as opposed to acute mesenteric ischemia that affects the small bowel.

The cause of 15% of all patients hospitalized for acute lower gastrointestinal bleeding, predominantly affecting the elderly.

Defined as a decrease in blood flow to a level that is insufficient to maintain colon cell metabolic function.

Manifests has a spectrum of processes including a reversible colopathy with submucosal or intramural hemorrhage or edema, transient colitis with mucosal ulceration, chronic colitis, stricture, gangrene, and fulminant universal colitis.

Incidence for fold greater over the past 34 years and is found to be 16 cases per hundred thousand person-years.

More common in women.

Mortality rates range from 4-12%.

Only 10% of patients presenting with colon ischemia with abdominal pain and bloody diarrhea are diagnosed at the time of presentation.

There is a low initial diagnostic rate because of the broad differential diagnosis, nonspecific symptoms, the presence of multiple coexisting comorbidities, and difficulty in identifying an inciting or precipitating cause.

The main mechanisms responsible for colon ischemia include: nonocclusive colon ischemia, embolic and thrombotic arterial occlusion, and mesenteric venous thrombosis.

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