In conclusion, in routine clinical practice many cases of ischemic colitis are considered to have non-specific abdominal pain, so an emergency imaging examination (ultrasound or CT) is usually carried out without a specific clinical suspicion. In our experience ischemic colitis can be suspected with high reliability (high PPV) when an elderly patient with sudden abdominal pain and/or rectal bleeding shows segmental wall thickening of a long colonic segment ( > 10 cm) in the sonographic examination.
Because endoscopic features of ischemic colitis are nonspecific, this can help to improve further diagnosis. Moreover, our results support that ultrasound could be considered an alternative diagnostic technique to colonoscopy in high-risk cases or patients with contraindications.
