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Old 03-25-2010
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GIT Ischemic Colitis Best Initial Test!

If you have a patient with a possibility of ischemic colitis (after a surgery for acute aortic aneurysm) what is the next diagnostic choice .....Abdominal CT or Colonoscopy??
because I have had the two answers and I don't know when to use any of them
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Old 03-25-2010
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I think you should start with a CT and then proceed to endoscopy. CT is more readily available, faster as a procedure, less intervening and thus bearing lower risk, and may well rule out other possible causes of abdominal pain. In my opinion, endoscopy should be reserved for those pt's that the CT in non-conclusive. Perhaps a fellow with greater clinical experience could help out.
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Old 03-25-2010
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Default CT scan is the best

Yes, CT scan is the best initial diagnostic test and if it fails to show the ischemic colon you proceed to colonoscopy.
MR angiography has limited role and should not be picked as the answer.
Plain abdominal radiograph may be done in the beginning when you are still not suspecting ischemic colitis.
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Old 03-25-2010
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Also Ultrasound is not useful don't pick it as the answer.
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Old 08-20-2011
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Default ischemic colitis mx

in uw there was case of ischemic colitis
initially he do ct and was normal next step he done colonscopy not angio

he write angio is not imp only bf operation
but mtb say diffrent most accurate is angio
confused
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Old 08-20-2011
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Quote:
Originally Posted by miss patho View Post
in uw there was case of ischemic colitis
initially he do ct and was normal next step he done colonscopy not angio

he write angio is not imp only bf operation
but mtb say diffrent most accurate is angio
confused
what was the question in uw? next step in dx ? or accurate test ? or anyother?
answer changes with question they ask you . accurate test is not always next step in management . so can you give the last sentence of the question.

what i know is , initial step is is CT . if its normal u do colonoscopy with biopsy to dx ischemia . angiography( most accurate ) is done b4 surgery .
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Old 08-20-2011
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Quote:
Originally Posted by usmlekzz View Post
what was the question in uw? next step in dx ? or accurate test ? or anyother?
answer changes with question they ask you . accurate test is not always next step in management . so can you give the last sentence of the question.

what i know is , initial step is is CT . if its normal u do colonoscopy with biopsy to dx ischemia . angiography( most accurate ) is done b4 surgery .
next step ithink u r right
and good to notice after ct we do colonscopy not angio

thanks
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Old 08-30-2011
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in ischemic colitis initial test is ct if ct normal or equivocal then go for colonoscopy is next option, if in question asking for most accurate, best or definitive then go for angiography for ischemic after ct
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