Ischemic descending colon

Case contributed by Dr Jeremy Jones

Presentation

Severe left sided abdominal pain with guarding.

Patient Data

Age: 70 years
Gender: Female

Admission plain films

X-ray

Possible thickened descending colon wall.

No subdiaphragmatic free gas.

CT

Thickened and edematous bowel wall limited to the descending colon.  Some vascular calcification.

Case Discussion

The expanded history when the case was discussed with the clinical team included acute onset atrial fibrilation.  The lactate was raised and with the findings at CT, the clinical suspicion was for an ischemic etiology.

Ischemic colitis was confirmed at surgery and a left hemicolectomy performed.

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