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1. Understand the anatomy
and physiology of splanchnic circulation.
2. Understand the
pathophysiology of ischemic bowel disease.
3. Realize the importance
of differentiating superficial (mucosal and submucosal) from deep (transmural) necrosis.
4. Be aware of the risk
factors that may lead to intestinal ischemia.
5. Develop a high index of
suspicion for the possibility of acute mesenteric ischemia in an emergent patient with
extremely severe abdominal pain.
6. Learn to act immediately
when this condition is suspected, as delay may lead to rapid necrosis of the bowel.
7. Understand the value of
the different imaging techniques used in acute mesenteric ischemia.
8. Learn the methods of
management of acute mesenteric ischemia.
9. Become aware of the
possibility of chronic mesenteric ischemia in a certain group of patients who present with
unexplained postprandial abdominal pain.
10. Learn to consider
nongangrenous ischemia in localized small bowel disease.
11. Suspect nongangrenous
ischemic colitis in patients with severe crampy abdominal pain and hematochezia.
12. Learn the risk factors
that can lead to nongangrenous ischemic colitis.
13. Understand the
differences between imaging techniques used in nongangrenous ischemic colitis and those
used in acute mesenteric ischemia.
14. Learn the problems
involved in differentiating nongangrenous ischemic colitis from inflammatory bowel disease
or infectious colitis.
15. Understand the natural
history and evolution of nongangrenous ischemic colitis.
16. Learn to be aware of
possible progression of acute ongoing nongangrenous disease to toxic megacolon and
occasionally to transmural necrosis.
17. Understand the problems
involved in managing nongangrenous ischemic colitis during its acute and chronic phases. |