Investigations
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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