Ischemic colitis is observed in people of older age groups (60-70 years and older) suffering from chronic diseases of the heart, common atherosclerosis of the aorta and its branches, the aneurysm of the abdominal aorta, the damage to the mesenteric vessels, etc.
Content
Classification of ischemic colitis
- Gangrenous shape of ischemic colitis.
- Transient ischemic colitis.
- Stricturing a form of ischemic colitis, as the outcome of the transient form.
Syptoms of ischemic colitis
Gangrenous shape of ischemic colitis. This form is preceded by heart
Insufficiency from various reasons (myocardial infarction, heart patterns, etc.). In addition to
sharp pain in the stomach and shock, the first plan is diarrhea and bleeding,
The reason for which is the necrosis of the intestinal wall. In case of inspection, detected
Signs of shock, irritation of peritoneum, bleeding. Death occurs in 50% of patients.
Transorted form of ischemic colitis occurs more often. Differs sudden
The appearance of small grapple-shaped pain in the left ileal region with frequent
Tenses, and after a day, diarrhea appears with bright or dark blood. Pain in the go
Tolstoy intestine arising 15-20 minutes after meals and eating through
1-3 hours, has a certain diagnostic value, t.To. It testifies O
Insufficiency of mesenterial blood flow. For ischemic colitis peculiar
Small bleeding, so massive bleeding speaks against this form
Pathology. Prolonged pains (within a few days) indicate
Development of organic changes in the intestinal wall and process progression. At
This also includes signs of heart disease, atherosclerosis, hypertensive
Diseases.
The outcome of the transient colitis form may be a recovery or aggravated process with
Development Stricture. In the first case, organic disorders are limited to
The mucous membranes and the submissible layer of intestine, the symptoms disappear within a few days. In
The second case is beginning to develop symptoms of partial intestinal obstruction.
Long grapple-shaped pain and diarrhea (or constipation) indicate the formation
Stricks, so this form is called stricture colitis. Process
extends deep into the submucosal layer and even the muscle shell that
necrotize and then replaced with granulation tissue followed by development
Fibrous stricture. The latter are most often formed in the region of the spleen corner
colon and can even be in the rectum.
Diagnosis of ischemic colitis
Smooth or gear out (teeth saw). Thickening and hemorrhage create a picture
comparable S «Fingerprints of thumb» - it is the most important diagnostic
Sign. Basch-shaped digging of the intestine due to education
Pseudo-deiversity with a wide mouth are the second important feature. Further
X-ray signs completely disappear, however, in some cases they can
persist. The appearance of the tubular nature of the colon damage at
Ischemic Colitis often causes a suspicion of cancer.
No less important method of examination is selective spryy angiography,
When conducting visible stenosis and ferry of arteries: no
contrasting the main artery, retrograde filling of the branches and then the trunk
Arteries.
RectorOnoscopy helps in the diagnosis during the localization of the process in distal
Departments of the colon. There are signs of swelling and looseness of mucosa, places
Green or Dark Green Films.
Fibrocolonoscopy with biopsy is used to clarify the diagnosis.
Differential diagnosis is carried out with ulcerative colitis, Crohn's disease,
Diverticulitis, cancer. It should take into account the age of the patient, the presence of pathology
Hearts and vessels, hypertension, short-term colit history.
Ulcerative colitis almost always proceeds with the defeat of the rectum, ischemic -
spley corner. Crown's disease proceeds often with arthritis and other systemic manifestations, which is not with ischemic colitis.
Treatment of ischemic colitis
Antispasmodics, analgesics Reoprotectors. In addition, correction is carried out
Water-electrolyte balance, antiagregants. When connected
Infectious-inflammatory process prescribe antibiotics, sulfonamides.
In parallel, the treatment of cardiovascular pathology is necessary.
With strict form, the operational treatment is shown.
