Related Lesions and Differential Diagnosis of Ischemic Colitis

Abstract

It is sometimes quite difficult to diagnose ischemic colitis because there are many lesions which reveal similar findings clinically, radiologically, and endoscopically. Definite ischemia and inflammation of the bowel wall were occasionally demonstrated so that various manifestations are shown according to the period from the onset of attack. Although some lesions are clearly due to ischmia, such as obstructive colitis and irradiation proctocolitis, they are given different clinical entity because of possibly different therapeutic methods. Therefore, ischemic colitis should be ruled out from some fundamental vascular pathologies as shown in Table 1.
According to the phase of ischemic colitis, differential diagnosis has to be performed. Patient's history, complaints, physical findings, laboratory data would suggest the possibility of this lesion rather than examination results. In endoscopical point of view, differential diagnosis should be performed according to the prominent finding and surrounding changes of the diseased segments as shown in Table 2. Angiography is occasionally helpful and histopathological study of biopsy, specimens is not specific to mke the diagnosis. Therefore, serial and repeated examinations are recommended for the differential diagnosis from soon after the initial episode to inactive phase.