USMLE Forums banner
1 - 5 of 5 Posts

·
Registered
Joined
·
24 Posts
Discussion Starter · #1 ·
A 72-year-old man status post–coronary artery bypass graft (CABG) 5 years ago presents with hematochezia, abdominal pain, and fevers. Colonoscopy reveals patches of dusky-appearing mucosa at the splenic flexure without active bleeding. Which of the following is the most appropriate management of this patient?
A. Angiography with administration of intra-arterial papaverine
B. Emergent laparotomy with left hemicolectomy and transverse colostomy
C. Aortomesenteric bypass
D. Exploratory laparotomy with thrombectomy of the inferior mesenteric artery
E. Expectant management
 

·
Registered
Joined
·
138 Posts
The answer is e. (Townsend ,pp1441-1443)

Ischemic colitis presents as hematochezia, fever, and abdominal pain.

Unlike acute mesenteric ischemia, which affects the small intestine and requires emergent intervention, ischemic colitis rarely requires surgical intervention unless full-thickness necrosis, perforation, or refractory bleeeding are present.

Expectant management with intravenous fluids, bowel rest, and supportive care is the treatment of choice.​
 

·
Registered
Joined
·
14 Posts
The answer is e. (Townsend ,pp1441-1443)

Ischemic colitis presents as hematochezia, fever, and abdominal pain.

Unlike acute mesenteric ischemia, which affects the small intestine and requires emergent intervention, ischemic colitis rarely requires surgical intervention unless full-thickness necrosis, perforation, or refractory bleeeding are present.

Expectant management with intravenous fluids, bowel rest, and supportive care is the treatment of choice.​
Informative but very tough :rolleyes:
 
1 - 5 of 5 Posts
This is an older thread, you may not receive a response, and could be reviving an old thread. Please consider creating a new thread.
Top