When is surgery indicated in ischemic colitis

When is surgery indicated in patients with ischemic colitis? 

Surgery is indicated in patients who present with or develop peritoneal signs, massive bleeding, gangrene or perforation, evidence of toxic megacolon, or fulminant colitis.

It should be considered even with apparent healing in patients who have recurrent bouts of sepsis and in patients who fail to respond to conservative measures over 2 to 3 weeks.

Symptomatic colon strictures may also warrant surgical or endoscopic correction (e.g., balloon dilation or stent placement).

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