Ischemic colitis: Difference between revisions
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=Ischemic Colitis= | |||
==Pearls== | |||
The following pearls copied from Shannon Thompson’s article from emDOCs.net<ref>[http://www.emdocs.net/ischemic-colitis-ed-presentations-evaluation-and-management/ Shannon Thompson. Ischemic Colitis: ED Presentations, Evaluation, and Management emDOCs.net] Permission to reproduce via Creative Commons Attribution 4.0 International License per emDOCS.net</ref> | |||
*''Consider ischemic colitis as the possible cause of '''acute-onset abdominal pain with rectal bleeding in patients age 50 and older with cardiovascular morbidities'''.'' | |||
*''For patients with peritoneal signs, radiographs should be considered for evaluation of '''ileus (air fluid levels), thumbprinting, pneumatosis coli, or pneumoperitoneum'''.'' | |||
*''Consider ordering a '''CTA''' as first-line imaging, especially if there is any suggestion of mesenteric ischemia, right sided tenderness without hematochezia, or if you suspect severe disease. If resources do not allow, order a CT with oral and IV contrast. If IRCI is incidentally found on initial CT, then CTA can be deferred to the inpatient setting and obtained prior to discharge.'' | |||
*''Give '''antibiotics''' in suspected ischemic colitis if the patient has '''any of the factors associated with severe disease'''.'' | |||
*''Place an emergent surgical consultation for any patient with '''peritoneal signs on physical exam or pneumatosis coli, portal venous gas, pan-colonic distribution, or isolated right-colon ischemia on imaging'''.'' | |||
==See Also== | |||
*[[Colitis]] | |||
*[[Mesenteric ischemia]] | |||
==References== | |||
Revision as of 13:33, 9 December 2019
Ischemic Colitis
Pearls
The following pearls copied from Shannon Thompson’s article from emDOCs.net[1]
- Consider ischemic colitis as the possible cause of acute-onset abdominal pain with rectal bleeding in patients age 50 and older with cardiovascular morbidities.
- For patients with peritoneal signs, radiographs should be considered for evaluation of ileus (air fluid levels), thumbprinting, pneumatosis coli, or pneumoperitoneum.
- Consider ordering a CTA as first-line imaging, especially if there is any suggestion of mesenteric ischemia, right sided tenderness without hematochezia, or if you suspect severe disease. If resources do not allow, order a CT with oral and IV contrast. If IRCI is incidentally found on initial CT, then CTA can be deferred to the inpatient setting and obtained prior to discharge.
- Give antibiotics in suspected ischemic colitis if the patient has any of the factors associated with severe disease.
- Place an emergent surgical consultation for any patient with peritoneal signs on physical exam or pneumatosis coli, portal venous gas, pan-colonic distribution, or isolated right-colon ischemia on imaging.
See Also
References
- ↑ Shannon Thompson. Ischemic Colitis: ED Presentations, Evaluation, and Management emDOCs.net Permission to reproduce via Creative Commons Attribution 4.0 International License per emDOCS.net