Colitis

Colitis

1. iscahemic

   • acute, rapid onset
     • pain
     • bloody stool
   • risk of reperfusion injury
   • Griffith's point (SMA/IMA transition)
   • Sudek's point (IMA/rectosigmoid transition
   • imaging
     • thumbprinting
     • thickening of bowel wall
     • loss of haustrations
     • vessel thrombosis
     • bleeding
   • 20% mortality

2. pseudomembranous

   • C. difficile
     • Gram +ve
     • anaerobic
     • spore-forming
     • toxin A (enterotoxin)
     • toxin B (cytotoxin)
   • mortality 25% in elderly
   • pancolitis 50%
   • complications
     • fulminent colitis
     • toxic megacolon
     • perforation
   • imaging
     • thickening
     • no surrounding inflammatory change
     • ascites

3. other infectious

   • shigella
     • right side colon
   • salmonella
     • right side colon
   • CMV
     • immunosuppressed
     • apthous ulcers, pan colitis and ascites