Ischaemic colitis describes an acute but transient compromise in the blood flow to the large bowel. This may lead to inflammation, ulceration and haemorrhage. It is more likely to occur in 'watershed' areas such as the splenic flexure that are located at the borders of the territory supplied by the superior and inferior mesenteric arteries.

Can be acute or chronic

Over 50% motality in acute mesenteric ischaemia

Common predisposing factors

• increasing age
• atrial fibrillation - particularly for mesenteric ischaemia
• other causes of emboli: endocarditis, malignancy
• cardiovascular disease risk factors: smoking, hypertension, diabetes
• cocaine: ischaemic colitis is sometimes seen in young patients following cocaine use

PC (bowel ischaemia)

• abdominal pain - in acute mesenteric ischaemia this is often of sudden onset, severe and out-of-keeping with physical exam findings
• rectal bleeding
• diarrhoea
• fever

Investigations

Bedside examinations:

• ECG - AF, arrhythmia, acute MI