Colon ischemia

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Author: Mikael Häggström [note 1]


Generally 10% neutral buffered formalin. Causes include volvulus and arterial occlusion.


On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Gross examination

  • Measure specimen length
  • Measure smallest and largest diameter
  • Describe serosa (color, adhesions) and mesentery
  • If a volvulus is still twisted, describe the twist and measure its distances from the resection margins
  • Open the bowel. Most will be filled with air, others filled with feces
  • Describe the mucosa - color, presence or absence of mucosal folds
  • Measure the thickness of the bowel wall
  • Sections submitted for microscopy:
  • Resection margins
  • Transition between normal and abnormal
  • Any mesenteric abnormality or enlarged lymph node

Gross report


( Countainer is labeled: ____ ). The specimen (is received in formalin and) consists of of bowel measuring __ cm in length(, __ cm in diameter) and __ cm in thickness. The bowel grossly appears edematous. (Representative sections are submitted for microscopic examination in __ cassettes.)

Further information: Colon

Microscopic examination

The main signs of colon ischemia are:[1]

  • Thrombosis, which are often hyaline, in small vessels
  • Necrosis, ulceration and granulation tissue, extending into submucosa and surrounding smooth muscle fibers of muscularis mucosa
  • Hemorrhage and edema in lamina propria


  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page


  1. Hanni Gulwani. Colon nontumor - Noninfectious colitis - Ischemic colitis. PathologyOutlines. Topic Completed: 1 May 2013. Revised: 8 January 2019, last major update May 2013

Image sources