Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Other diagnostic factors

  • haematochezia/melaena
  • diarrhoea
  • abdominal tenderness
  • weight loss
  • abdominal bruit
  • vasculitis
  • light headedness, pallor, dyspnoea
  • food fear (sitophobia)

Risk factors

  • old age
  • history of smoking
  • hyper-coagulable states
  • atrial fibrillation
  • myocardial infarction
  • structural heart defects
  • history of vasculitis
  • recent cardiovascular surgery
  • shock
  • congestive heart failure
  • atherosclerosis
  • previous ileostomy
  • irritable bowel syndrome
  • colonic carcinoma
  • constipation
  • long-term laxative use
  • use of vasopressors, digitalis, cocaine

Diagnostic investigations

1st investigations to order

  • FBC
  • chemistry panel
  • arterial blood gas/lactate level
  • ECG
  • erect CXR
  • abdominal x-rays
  • sigmoidoscopy or colonoscopy
Full details

Investigations to consider

  • mesenteric angiography
  • CT scan with contrast/CT angiogram
  • barium enema
  • mesenteric duplex ultrasound
  • magnetic resonance angiograph (MRA)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Medical Director

Swedish Colon and Rectal Clinic

Program Director

Swedish Colon and Rectal Surgery Training Program

Swedish Medical Center

Seattle

WA

Disclosures

AB declares that he has no competing interests.

Dr Amir Bastawrous would like to gratefully acknowledge Dr Jennifer Holder-Murray and Dr Alessandro Fichera, the previous contributors to this monograph. JHM and AF declare that they have no competing interests.

Peer reviewers VIEW ALL

Assistant Professor of Surgery

Department of Surgery

University of California, Los Angeles

Los Angeles

CA

Disclosures

FC declares that she has no competing interests.

Assistant Professor of Surgery

Division of Colon and Rectal Surgery

University Hospital Case Medical Center

Cleveland

OH

Disclosures

SS received a fee for educational courses on laparoscopic surgery, paid for in part by Covidien, Olympus, and Applied Medical.

Associate Professor of Colon and Rectal Surgery

Department of Surgery

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

CK declares that he has no competing interests.

General Surgeon

General Surgery Department

Istanbul Training and Research Hospital

Istanbul

Turkey

Disclosures

GC is an author of a number of references cited in this monograph.

Consultant Gastroenterologist

St George’s Hospital

London

UK

Disclosures

AP declares that he has no competing interests.

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