A patient with ischemic colitis may be managed with or without surgery. Surgery is indicated when certain findings are present.


Indications for surgery:

(1) presence of peritoneal signs indicative of fulminant colitis, intestinal gangrene, and/or perforation with peritonitis (distension, guarding, rigidity, pain))

(2) massive hemorrhage

(3) recurrent fever or sepsis

(4) symptoms lasting more than 3 weeks

(5) chronic protein-losing enteropathy

(6) chronic segmental colitis with ulceration

(7) symptomatic ischemic stricture


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