Gastro: Ischaemic Colitis: Free MSRA Podcast

⚕️FREE MSRA PODCAST –Ischaemic Colitis🎧 A clear, high-yield breakdown of this vascular emergency affecting thecolon – perfect for exam prep andreal-life clinical scenarios. 🧠Key Learning Points📌Definition• Ischaemic Colitisis inflammation and injury of the colondue to reduced blood flow, most commonlyaffecting the splenic flexure and rectosigmoid junction — the classic watershed areas. 📌Causes & RiskFactors• Systemic hypotension (e.g. shock, dehydration)• Atherosclerosis and arterial thromboembolism• Vasculitis (e.g. lupus, PAN)• Low cardiac output and arrhythmias• Vasoconstrictive drugs (e.g. digitalis,cocaine)• Recent abdominal surgery• Hypercoagulable states (e.g. protein C/Sdeficiency, APC resistance)• Age >60, smoking,and cardiovascular diseaseMnemonic: SHOVeLShock, Hypotension, Occlusion, Vasculitis, Elderly,Lifestyle factors 📌Pathophysiology• Reduced blood flow→ colonic ischaemia, especially inwatershed zones• Leads to hypoxia, triggering inflammation and mucosal damage• May extend tofull-thickness necrosis if severe 📌Symptoms• Sudden crampy abdominal pain (typically leftiliac fossa)• Bloody diarrhoea or rectal bleeding• Nausea, vomiting,and tender abdomen• In severe cases → signs of peritonitis, shock, or feverMnemonic: Pain,Poo, and Blood 📌DifferentialDiagnosis• Diverticulitis• Infective colitis (e.g. dysentery)• Inflammatory bowel disease (Crohn’s, UC)• Appendicitis (especially atypicalpresentations)• Bowel perforation, pancreatitis, peritonitis 📌Diagnosis• Bloods: FBC, CRP/ESR, U&Es, lactate (mayshow acidosis)• Colonoscopy: Segmental changes, bluish swollenmucosa, sparing of rectum• CT Abdomen with contrast: Bowel wallthickening, pericolonic fat stranding• CT Angiography: Assesses for vascular occlusion• Barium enema (less common): Thumbprinting due to submucosal oedema 📌ManagementSupportive Care• Bowel rest (NPO),IV fluids, electrolyte correction• Good analgesiaMedical Management• Broad-spectrum antibiotics (e.g. co-amoxiclav)to prevent bacterial translocationSurgical Intervention (if)• No improvementafter 24–48 hours• Worsening signs —peritonitis, increasing pain, fever• Suspected infarction or perforation• Emergency laparotomy if bowel necrosis issuspected 📌Complications• Bowel infarction and necrosis• Perforation leading to peritonitis• Stricture formation and chronic colitis• Sepsis and systemic complications 📌Prognosis• Good in mild cases— complete recovery with supportive care• Poorer prognosisin elderly, extensive disease, or if emergencysurgery required• Overall mortality rate ~22% in severe cases 📎More MSRA Resourcesfor Ischaemic Colitis📝 Revision Notes:https://www.passthemsra.com/topic/ischaemic-colitis-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/ischaemic-colitis-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/ischaemic-colitis-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/ischaemic-colitis-rapid-quiz/🎓 Full Course:https://www.passthemsra.com/courses/gastroenterology-for-the-msra/ #MSRA #MSRARevision#MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQandANotes#MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision#MSRARevisionWebsite #IschaemicColitis