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Phase 2a GI > Bowel Ischemia (ischemic Colitis & mesenteric ischemia) > Flashcards

Bowel Ischemia (ischemic Colitis & mesenteric ischemia) Flashcards

1
Q

Definition of ischemic colitis

A

Ischemia of the colonic arterial supply, colon inflamed due to hypo perfusion

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2
Q

Which artery does IC affect?

A

Inferior mesenteric artery (IMA)

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3
Q

Causes of IC

A

Thrombosis (+/- atherogenesis) - MC
Emboli
Decreased CO + Arrhythmias (eg. Hx of AF) eg. shock
(+ COCP)

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4
Q

What are the MC sites affected and why?

A

Watershed areas (most distal)
Splenic flexure (MC)
Sigmoid colon and cecum

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5
Q

Symptoms of IC

A

LLQ pain and bright bloody stool (+/- signs of hypovolemic shock)

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6
Q

How to diagnose IC?

A

Colonoscopy + Biopsy - GS
(often after Px fully recovered, prevents stricture formation + normal healing)
Rule out other causes (eg. stool sample - H.Pylori)

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7
Q

Treatment for IC

A

Symptomatic - IV Fluid + Abx (prophylactic)
Gangrenous - only SURGERY

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8
Q

Complications of IC

A

Perfusion (therefore SBP)
Strictures (therefore obstruction)

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9
Q

What is mesenteric ischemia?

A

Ischemia of the small bowel

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10
Q

What are the 2 types of mesenteric ischemia?

A

Acute and chronic

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11
Q

Chronic mesenteric Ischemia
What is it caused by?
How long does it last?
What does it lead to?
What is it also referred to?

A

Narrowing of BV due to atherosclerosis
Longer lasting, over months
Leads to intermittent abdo pain
‘Abdo angina’

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12
Q

Symptoms of CMI: TRIAD

A

Central colick abdo pain after eating (30 mins after for 1-2 hours)

Weight loss - food avoidance

Abdominal bruits - whooshing through BV

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13
Q

Diagnosis of CMI

A

CT Angiogram

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14
Q

Acute mesenteric Ischemia
What is it caused by?
What is it also referred to?

A

Acute attack, rapid blockage
Due to thrombus/embolus
‘Abdominal MI’

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15
Q

Sx of AMI: TRIAD

A

Central/RIF acute severe abdo pain

No abdo signs on exam (eg. guarding, rebound tenderness)

Rapid hypovolemic shock

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16
Q

Causes of Mesenteric ischemia

A

Thrombus - MC
Emboli (due to AF often)

17
Q

How does AF cause an embolus

A

Forms in left atrium, to aorta to SMA

18
Q

What artery is affected by Mesenteric ischemia?

A

Superior mesenteric artery

19
Q

Diagnosis of AMI

A

CT Angiogram
FBC & ABG = persistent metabolic acidosis
high lactate

20
Q

Why does acute mesenteric ischemia have these blood results?

A

due to ischemia = anaerobic resp = lactate = acidic

21
Q

Treatment for MI

A

Fluid resus (due to hypovolemic)
Abx and IV Heparin (reduce thromboemboli)

Infarcted bowel = surgery

22
Q

Comp of MI

Phase 2a GI (14 decks)

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