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Ischemic colitis — ABEM Board MCQ

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HardGI/Abdominal emergenciesIschemic colitisABEM Board

A 59-year-old woman presents as triage level 2 with left lower quadrant pain and hematochezia after a hypotensive dialysis episode. CT shows segmental colitis at the splenic flexure without perforation; lactate is normal. Which of the following is the most appropriate disposition?

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Correct answer: E — Admission for bowel rest, IV fluids, serial exams, and surgical consultation if deterioration occurs

Ischemic colitis after low-flow state often needs inpatient supportive care and monitoring; surgery is reserved for peritonitis, gangrene, or clinical worsening.

Reference: ACG colon ischemia guidance; ABEM EM Model