Treatment of Ischemic Colitis

Abstract

The management of the three types of ischemic colitis is described. Transient form is treated conservatively by nothing per os, intravenous fluid, antibiotics, etc. under observation with colonoscopy and barium enema study. Stricturing form can be treated by one-stage resection and anastomosis. Gangrenous from requires an emergency operation for excision of the necrotic intestine. Construction of a proximal and distal colostomy is preferable to anastomosing the divided ends of intestine. This greatly reduces the operating time and would be safer. But, provided care is taken to ensure complete clearance of the ischemic intestine and operation is performed before perforation, primary anastomosis can be performed safely. Prognosis of patients with ischemic colitis without intestinal gangrene seems to be good, but that of patients with gangrenous form is poor. Information on recurrences has not yet been published.