Esophagus Stomach Duodenum Capsule Endoscopy Inflammatory Bowel Disease Colon & Ileum Miscellaneous

Ischemic Colitis

Colonoscopic findings in a 78 year-old woman who presented with painless rectal bleeding. These four images reflect mucosal changes of ischemia (inadequate blood supply) in increasing severity, from patchy erythema (upper left) to frank ulceration (lower right).

Left: 77 year-old woman with rectal bleeding. Colonoscopy revealed broad ulcers with overlying exudate, and mucosal friability.

Right: 71 year-old woman with vomiting and bloody diarrhea. Colonoscopy revealed severe colitis with ulcers and diffuse mucosal oozing of blood.

Severe ischemic colitis in the ascending colon of a 60 year-old man with four months of increasing abdominal pain and weight loss. Findings included multiple focal abcesses (left) and areas of confluent ischemia bordering on necrosis (right).

75 year old man developed abdominal distention, persistent hypotension and acidosis folowing surgical repair of a ruptured abdominal aortic aneurysm, raising suspicion of ischemic bowel. Colonoscopy demonstrated diffuse mucosal pallor likey due to vasoconstriction casued by high dose pressors. Otherwise the cecum, ascending and transverse colon appeared normal. There was an abrupt transition to abnormal mucosa at the splenic flexure with purple discoloration, superficial ulceration, patchy exudate and loss of normal vascular pattern. There was a second abrupt transition to normal mucosa at the rectosigmoid junction.

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