It occurs in splenic flexure where blood supply is precarious. Splenic flexure is the water shed area of colon, receiving blood supply from terminal branches of superior and inferior mesenteric arteries.
Ischaemic colitis is common in females, common in aged.
It is related to atherosclerosis, emboli, vasculitis, diabetes, chronic renal failure, autoimmune diseases, polycythaemia, haemodialysis, etc.
Water shed point—Griffith’s point in artery of Riolan gets poor perfusion by arterial disease,low perfusion pressure/altered viscosity causing ischaemic colitis.
Types -Marston’s Classification
- Gangrenous type—ischaemia of full thickness colon causing peritonitis
- Stricture type— ischaemia of muscularis layer causing scarring.
- Transient type—most vulnerable layer, mucosal involvement usually recovers completely.
CLINICAL FEATURES OF ISCHAEMIC COLITIS
- Pain in left iliac fossa and left hypochondrium.
- Passing blood in the stool.
INVESTIGATION OF ISCHAEMIC COLITIS
- Plain X-ray reveals ‘thumb printing sign’ due to mucosal oedema and submucosal haemorrhage.
- CT scan shows colonic wall thickening with posterior fat shadowing.
- barium enema
- sigmoidoscopy or colonoscopy is avoided due to risk of perforation
HOMOEOPATHIC MEDICINE FOR ISCHAEMIC COLITIS
- MERCURIOUS SOL
- ARGENTUM NITRICUM
- ALOE SOCOTRINA
- ATISTA RADIX
- CEPHALANDRA INDICA