%0 Journal Article
%T Is CT Angiogram of the Abdominal Vessels Needed following the Diagnosis of Ischemic Colitis? A Multicenter Community Study
%A Muhammed Sherid
%A Salih Samo
%A Samian Sulaiman
%A Husein Husein
%A Sankara N. Sethuraman
%A John A. Vainder
%J ISRN Gastroenterology
%D 2014
%R 10.1155/2014/756926
%X Background. CT angiogram is frequently obtained after diagnosis of ischemic colitis (IC). Aims. To investigate the vascular findings of CT angiogram as compared to contrast-enhanced CT scan and whether this modality changes the management or prognosis of IC. Methods. We conducted a retrospective analysis of patients with IC from 2007 to 2013. Results. CT angiogram was performed in 34 patients (28.81%), whereas contrast-enhanced CT scan was performed in 54 patients (45.76%). In CT angiogram group, 8 patients (23.5%) had atherosclerotic changes. Stenosis was found in 12 patients (35.3%) (9: celiac trunk, 3: SMA). Among this group, one patient underwent colectomy and another underwent angioplasty of the celiac trunk who died within 30 days. Among contrast-enhanced CT scan group, 5 patients (9.3%) had atherosclerotic changes. Stenosis was found in 5 patients (9.3%) (3: celiac trunk, 1: SMA, and 1: IMA). Among this group, 3 patients had colectomy and one died within 30 days. There was no statistical difference between both groups in all vascular findings except the stenosis which was higher in CT angiogram group ( ). Neither the need for surgery nor all-cause mortality was different between both groups. Conclusion. CT angiogram did not provide any useful findings that altered the management or the prognosis of IC. 1. Introduction Blood circulation of the gastrointestinal (GI) tract consists of three major splanchnic arteries which supply the stomach to the rectum: celiac trunk, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA). The colon is protected against ischemia by a rich collateral blood circulation; however, these collateral networks are considered relatively limited as compared to those in the stomach and the small bowel. The two main arteries supplying the colon are the SMA and the IMA. The vascular anatomy of colonic vessels is highly variable between individuals, exposing the colon to ischemia especially in the watershed areas and the right colon [1]. Splenic flexure (Griffiths¡¯ point) and rectosigmoid junction (Sudeck¡¯s point) are known as watershed areas because of the critical points of blood flow between two different vascular supplies: the SMA and the IMA and the IMA and the internal iliac artery, respectively [1¨C5]. The marginal vessel is poorly developed in the right colon in up to 50% of people, making the right colon susceptible to ischemic colitis [1]. Mesenteric (bowel) ischemia is classified into three entities which vary in their etiologies, presentation, management, and prognosis: ischemic colitis, acute
%U http://www.hindawi.com/journals/isrn.gastroenterology/2014/756926/