Systematic Review of the Management of Ischaemic ColitisS. O’Neill, S. Yalamarthi. Colorectal Disease Accepted manuscript online: 7 JUL 2012 09:10AM EST Aim: The study reviewed the literature related to ischaemic colitis (IC) to establish an evidence base for its management and to identify factors predicting severity and mortality). Method: A systematic review of the English language literature was conducted according to recommendations of the PRISMA statement. MEDLINE, Embase and Cochrane Library databases were searched using the key word search: “IC OR colon ischaemia OR colonic ischaemia OR management IC”. IC is often misdiagnosed so only studies where the diagnosis was supported by histopathology in every case were included. Critical appraisal was performed of included studies using predefined quality assessment check lists and narrative data synthesis. Results: 2610 publications were identified. Of these eight retrospective case series and three case controlled studies including 1049 patients were included. Medical management was used in 80.3% patients of whom 6.2% died. Surgery was required in 19.6% of whom 39.3% died. The overall mortality of IC was 12.7%. Lack of rectal bleeding, peritonism and renal dysfunction were commonly quoted predictors of severity however right sided IC appeared to be the most significant predictor of outcome. Conclusion: Most patients with IC can be managed conservatively. Right sided IC may be the most significant predictor of severity.
