Ischemic Colitis

  • William Sangster
  • Evangelos MessarisEmail author


Ischemic colitis refers to a state of colonic injury secondary to inadequate blood flow. Colonic ischemia is the most common form of intestinal ischemia as the colon has fewer vascular collaterals as compared to the remainder of the gastrointestinal tract and can be more prone to episodes of diminished blood flow. Ischemic colitis occurs more frequently in the elderly, and risk factors include diabetes, vasculitis, congestive heart failure, hypercoagulable states, aortoiliac surgery, cancer, and certain drugs. The diagnosis and treatment of ischemic colitis can be challenging as it often occurs in patients who are debilitated and have multiple medical problems. The following chapter will provide a brief synopsis of the management of a patient who presents with suspicion for acute ischemic colitis.


Ischemic colitis Ischemia Colitis Colon Gastrointestinal Hypoperfusion Abdominal pain Hematochezia Bloody diarrhea Colonic emboli/thrombi 


  1. 1.
    Feuerstadt P, Brandt LJ. Colon ischemia: recent insights and advances. Curr Gastroenterol Rep. 2010;12(5):383–90.CrossRefGoogle Scholar
  2. 2.
    Mosele M, Cardin F, Inelmen EM, Coin A, Perissinotto E, Sergi G, et al. Ischemic colitis in the elderly: predictors of the disease and prognostic factors to negative outcome. Scand J Gastroenterol. 2010;45(4):428–33.CrossRefGoogle Scholar
  3. 3.
    Cruz C, Abujudeh HH, Nazarian RM, Thrall JH. Ischemic colitis: spectrum of CT findings, sites of involvement and severity. Emerg Radiol. 2015;22(4):357–65.CrossRefGoogle Scholar
  4. 4.
    Milone M, Di Minno MN, Musella M, Maietta P, Iaccarino V, Barone G, et al. Computed tomography findings of pneumatosis and portomesenteric venous gas in acute bowel ischemia. World J Gastroenterol. 2013;19(39):6579–84.CrossRefGoogle Scholar
  5. 5.
    Zou X, Cao J, Yao Y, Liu W, Chen L. Endoscopic findings and clinicopathologic characteristics of ischemic colitis: a report of 85 cases. Dig Dis Sci. 2009;54(9):2009–15.CrossRefGoogle Scholar
  6. 6.
    Brandt LJ, Feuerstadt P, Longstreth GF, Boley SJ. ACG clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon ischemia (CI). Am J Gastroenterol. 2015;110(1):18–44.CrossRefGoogle Scholar
  7. 7.
    O'Neill S, Yalamarthi S. Systematic review of the management of ischaemic colitis. Color Dis. 2012;14(11):e751–63.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of SurgeryPenn State Milton S. Hershey Medical CenterHersheyUSA
  2. 2.Division of Colon and Rectal SurgeryBeth Israel Medical Center, Harvard Medical CenterBostonUSA

Personalised recommendations