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OBJECTIVES page 286

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.
   

 

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