Physical Assessment for Suspected Oral Contraceptive-Related Ischemic Colitis

Vital Signs Assessment

• Measure pulse rate to detect tachycardia, which indicates severe disease activity or volume depletion 1
• Record blood pressure to assess for hypotension suggesting significant fluid loss or systemic compromise 1
• Document temperature as fever suggests severe colitis or potential complications including perforation or abscess 1
• Obtain weight and compare to baseline, as weight loss indicates chronic or severe active disease 1

Abdominal Examination

• Assess for abdominal distension which may indicate colonic dilatation or impending complications 1
• Auscultate bowel sounds as reduced or absent sounds suggest severe disease or complications 1

Rectal Examination

• Inspect the perianal region if clinically appropriate, though perianal disease is not typical of ischemic colitis 1

General Physical Findings

• Assess for signs of anemia including pallor, which may indicate chronic blood loss or severe active disease 1
• Evaluate for fluid depletion through skin turgor and mucous membrane assessment 1

Critical Pitfalls to Avoid

• Do not dismiss normal vital signs as excluding significant disease—physical examination may be unremarkable even with endoscopically confirmed ischemia 1
• Do not delay imaging if severe abdominal pain or distension is present, as CT imaging can identify complications including perforation, closed-loop obstruction, or bowel ischemia 3