investigations

Last reviewed 08/2021

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