Ischemic bowel disease

Ischemic bowel disease can be classified into three types: acute mesenteric ischemia, chronic mesenteric ischemia, and colonic ischemia. Acute mesenteric ischemia may also be further subdivided into embolic mesenteric ischemia, thrombotic mesenteric ischemia, venous mesenteric ischemia, and nonocclusive mesenteric ischemia. Colonic ischemia is the most common type and has the most favorable prognosis.

Ischemic bowel disease may present clinically in a number of ways, including transient reversible ischemia, chronic irreversible ischemia, or acute fulminant ischemia.

Mesenteric venous thrombosis may lead to acute or subacute intestinal ischemia and may also present across a spectrum of severity.

Short-term complications include small bowel infarction, hemorrhagic shock, peritonitis, gangrenous colitis, fulminant universal colitis, colonic perforation, pneumoperitoneum, colon wall necrosis leading to the formation of pneumatosis linearis coli and portal venous gas seen on imaging.

Long-term complications of ischemic bowel disease depend on the location and nature of the underlying pathology. Possible complications include stricture formation, short bowel syndrome, and food fear leading to malnutrition.

Ischemic bowel disease encompasses a heterogeneous group of disorders caused by acute or chronic processes, arising from occlusive or nonocclusive etiologies, which result in decreased blood flow to the gastrointestinal tract. The clinical course may range from transient and reversible to fulminant.​ [Figure caption and citation for the preceding image starts]: Histopathology of intestinal ischemiaFrom the collection of Dr Jennifer Holder-Murray; used with permission [Citation ends].