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Investigations

Authoring team

It may be difficult to distinguish the bleeding of ischaemic colitis from that due to inflammatory bowel disease, diverticulitis or carcinoma.

Diagnosis is usually established on the basis of:

  • plain abdominal x-ray - may reveal mucosal oedema at the splenic flexure, so called "thumb printing"; a single segment is affected with symmetrical stricture

  • barium enema - support x-ray findings; contra-indicated in acute illness because of risk of perforation

  • endoscopy - variable appearance from mild reddening to gangrene

  • histology:
    • intramucosal haemorrhage
    • fibrosis
    • haemosiderin - uncommon

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