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  • Ischaemic colitis is injury of large intestine that results from interruption of its blood supply. Caused by transient reduction in blood flow to colon. Most patients are elderly, but also occurs in younger ages associated with oral contraceptive use, vasculitis, hypercoagulable states. Clinical picture depends on degree and rate of development of ischemia. Acute fulminant ischaemic colitis: severe lower abdominal pain, rectal bleeding, and hypotension; dilatation of colon (severe cases); signs of peritonitis (severe cases). Subacute ischaemic colitis: most common clinical variant; produces lesser degrees of pain and bleeding (occurring over several days or weeks). Ischemic colitis is second most common cause of lower gastrointestinal bleeding. Diagnosis made by colonoscopy. Usually develops in absence of major vessel occlusion. Associated factors: decreased cardiac output; arrhythmia; trauma; surgery (e.g., aorto-iliac surgery); vasculitis; coagulation disorders; chronic obstructive pulmonary disease; irritable bowel syndrome; specific drugs. More than two thirds of patients respond to conservative measures (IV fluids, bowel rest, antibiotics). Surgery rarely required
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