Correct!
3. Colon resection
Therapy for ischemic colitis is controversial. In this patient, the choice was difficult because of her underlying disease. Most patients with left-sided colitis can be managed with conservative therapy (1). However, those with right sided colitis such as our patient have a poorer outcome and colon resection is more often performed.
The cause of her ischemic colitis is not entirely clear. However, Harel et al. (2) have reviewed several reports of oral sodium polystyrene sulfonate administration associated with ischemic colitis. The mechanism is not entirely clear but may be secondary to fluid and electrolyte shifts within the bowel or possibly a direct toxic effect of the sodium polystyrene sulfonate. Vasopressor administration may also have contributed to her ischemia.
She underwent a right hemicolectomy and made a quick and uneventful recovery. Later she underwent orthotopic liver transplantation and has done well.
References