CI is the most common cause of mesenteric ischemia, and encompasses a wide clinical spectrum from mild, reversible disease to life-threatening colonic gangrene. While most commonly seen in elderly patients, younger patients are also at risk, especially if an underlying risk factor such as vasculitis, hyper-coagulability, or certain medication use such as oral contraceptives, pseudoephedrine, cocaine, or ergot, is present. Colonoscopic evaluation is critical in the evaluation of patients with CI, although it must be kept in mind that CI may mimic or be mimicked by other entities, such as IBD or carcinoma. Conservative management usually leads to a full clinical recovery, although several subsets of patients may require segmental resection. Clinicians should always consider CI in the differential diagnosis of acute colitis, especially in elderly patients.
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