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Ischaemic colitis — RCPSC EM MCQ

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ModerateGI/Abdominal emergenciesIschaemic colitisRCPSC EM

CTAS 3: A 77-year-old develops crampy left lower-quadrant pain and bloody diarrhoea after a hypotensive dialysis episode. Vitals are BP 104/62, HR 106. Abdomen is tender without peritonitis. CT shows segmental left-sided colitis and thumbprinting. What is the most likely diagnosis?

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Correct answer: D — Ischaemic colitis

Older age, recent hypoperfusion, crampy pain and bloody diarrhoea with segmental colitis suggest ischaemic colitis. Peritonitis or deterioration requires surgical escalation.

Reference: Canadian gastroenterology emergency practice; Royal College EM Objectives