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