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Investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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

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